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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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