Please use this identifier to cite or link to this item: https://repository.monashhealth.org/monashhealthjspui/handle/1/43603
Title: Acute liver failure after changing oral anticoagulant from apixaban to rivaroxaban.
Authors: Rao V.;Munasinghe A.
Monash Health Department(s): Nephrology
General Medicine
Institution: (Rao) Department of General Medicine, Monash Medical Centre, Clayton, Melbourne, VIC, Australia
(Munasinghe) Department of Nephrology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia
Issue Date: 12-May-2021
Copyright year: 2021
Publisher: BMJ Publishing Group
Place of publication: United Kingdom
Publication information: BMJ Case Reports. 14 (4) (no pagination), 2021. Article Number: e240719. Date of Publication: 28 Apr 2021.
Journal: BMJ Case Reports
Abstract: Rivaroxaban is a commonly used anticoagulant agent for treatment and prevention of thromboembolism. There are case reports demonstrating an association between its use and drug-induced liver injury. However, this has not been reported in a patient who previously tolerated apixaban. An 88-year-old man presented to hospital with worsening lethargy, jaundice and vomiting. He had severely elevated liver transaminases, an abnormal coagulation profile and elevated bilirubin in keeping with acute liver injury. This is in the context of having had his anticoagulation medication switched from apixaban to rivaroxaban 2weeks prior. The patient recovered well after cessation of rivaroxaban, suggesting that it was the likely offending agent. The mechanism of rivaroxaban-induced liver injury remains to be investigated. Drug-induced liver injury should be discussed and monitored for as a potential adverse reaction when commencing rivaroxaban, even if a patient has previously tolerated a drug of the same class.Copyright © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.
DOI: http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1136/bcr-2020-240719
PubMed URL: 33910797 [http://www.ncbi.nlm.nih.gov/pubmed/?term=33910797]
URI: https://repository.monashhealth.org/monashhealthjspui/handle/1/43603
Type: Article
Subjects: activated partial thromboplastin time
acute liver failure/si [Side Effect]
anemia/di [Diagnosis]
arm weakness
atrial fibrillation/dt [Drug Therapy]
bilirubin blood level
body weight loss
bone marrow biopsy
bone marrow disease/di [Diagnosis]
carotid artery obstruction/di [Diagnosis]
colonoscopy
computed tomographic angiography
computer assisted tomography
disease exacerbation
disease severity
drug blood level
drug substitution
drug withdrawal
echography
erythrocyte
esophagitis/di [Diagnosis]
fatty liver/di [Diagnosis]
gastritis/di [Diagnosis]
gastroesophageal junction
gastroscopy
gene mutation
hemoglobin blood level
hyperbilirubinemia/di [Diagnosis]
hypertransaminasemia
international normalized ratio
jaundice
laboratory test
length of stay
lethargy
limb weakness
low drug dose
megakaryocyte
mortality
myeloid metaplasia/di [Diagnosis]
myelophthisic anemia/di [Diagnosis]
nausea
occult blood test
rectum disease/di [Diagnosis]
splenomegaly/di [Diagnosis]
thrombocytopenia/di [Diagnosis]
transient ischemic attack
treatment duration
very elderly
vomiting
acetylcysteine/pv [Special Situation for Pharmacovigilance]
aminotransferase/ec [Endogenous Compound]
apixaban/ae [Adverse Drug Reaction]
apixaban/dt [Drug Therapy]
apixaban/po [Oral Drug Administration]
apixaban/pv [Special Situation for Pharmacovigilance]
atorvastatin/pv [Special Situation for Pharmacovigilance]
bilirubin/ec [Endogenous Compound]
enoxaparin/dt [Drug Therapy]
enoxaparin/pv [Special Situation for Pharmacovigilance]
ferritin/ec [Endogenous Compound]
fresh frozen plasma/pv [Special Situation for Pharmacovigilance]
hemoglobin/ec [Endogenous Compound]
Janus kinase 2/ec [Endogenous Compound]
liver enzyme/ec [Endogenous Compound]
rivaroxaban/ae [Adverse Drug Reaction]
rivaroxaban/dt [Drug Therapy]
rivaroxaban/pv [Special Situation for Pharmacovigilance]
verapamil/pv [Special Situation for Pharmacovigilance]
vitamin K group/pv [Special Situation for Pharmacovigilance]
JAK2 gene
Type of Clinical Study or Trial: Case series or case report
Appears in Collections:Articles

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