Rash associated with rivaroxaban use

Abstract

A 69-year-old Caucasian woman developed a diffuse, exanthematous rash on day 3 of rivaroxaban treatment. Symptoms abated after rivaroxaban discontinuation and treatment with dexamethasone.

Bullous pemphigoid‐like skin rash associated with Rivaroxaban use in a very elderly patient with multimorbidity and chronic kidney disease: A case report

“…After reviewing the published case reports on skin reactions associated with rivaroxaban, a decision was taken to suspend rivaroxaban on 17 July 2019. Subsequently, the patient and his family did not want any further anticoagulation medication in view of the complications with rivaroxaban and his history of recurrent falls with physical injuries.…”

“…rivaroxaban is an example of a DOAC, and apart from bleeding, less common side effects include hepatobiliary toxicity, hair loss, skin reactions, and hypersensitivity reactions including anaphylaxis . There have been a number of reports of rash occurring with rivaroxaban use . A bullous‐like skin rash has been described in some of these studies, which may be mistaken for the condition of bullous pemphigoid.…”

“…2 There have been a number of reports of rash occurring with rivaroxaban use. [3][4][5][6] A bullous-like skin rash has been described in some of these studies, 7 which may be mistaken for the condition of bullous pemphigoid. Manufacturers warn of the following dermatologic adverse reactions in the package insert of wound secretions (3%), pruritus (2%), and skin blister (1%).…”

Hypersensitivity reactions to non-vitamin K oral anticoagulants - a review of literature and diagnostic work-up proposal

“…The patient subsequently tolerated switch to warfarin. Milder delayed hypersensitivity reactions included drug-induced rashes described as morbilliform eruption (24) or urticarial rash (25) without systemic symptoms and internal organs' involvement, fading after steroids and drug discontinuation. These reactions developed within the first week of treatment (day 2 and day 7, respectively).…”

Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case

“…In the treatment of patients with venous thromboembolism (VTE) and atrial fibrillation (AF), direct oral anticoagulants (DOACs) have overshadowed warfarin due to less intracranial bleeding, simplified dosing, and predictable pharmacokinetics compared to warfarin [ 1 , 2 ]. Although, a growing number of reports of adverse drug reactions such as drug eruptions, urticaria, lichenoid eruption, and exanthematous rash have been published [ 2 - 4 ], anaphylaxis due to DOACs is extremely rare. Of 7111 participants in the rivaroxaban treatment arm of the ROCKET-AF study, anaphylaxis was found in 0.01% of cases [ 3 ].…”