Isolated hemopericardium after initiation of rivaroxaban: Implications and potential mechanisms

Clinics and Practice
Adwait MehtaNilesh Mathuria

Abstract

Direct oral anticoagulants have become increasingly used for atrial fibrillation and venothromboembolic disease. Thus far, there have been a few published cases of pericardial effusion associated with rivaroxban. However, there has been little published regarding the effects of concurrent medications and their effect on the cytochrome enzyme systems involved in rivaroxaban metabolism. We present a case of a 76-year-old female who develops a spontaneous haemopericardium after initiating rivaroxaban. After thorough medical reconciliation, we offer pharmacokinetic mechanisms that may have contributed to the haemopericardium. This case demonstrates the importance of reviewing patients medication lists and utilizing basic pharmacokinetics to prevent adverse events.

References

Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Jul 13, 2012·The Annals of Pharmacotherapy·Eliza A Dy, Dane L Shiltz
Sep 4, 2013·Clinical Pharmacokinetics·Wolfgang MueckMichael Becka
Mar 25, 2014·European Heart Journal·Jonathan P PicciniUNKNOWN ROCKET AF Investigators
May 6, 2014·International Journal of Cardiology·Bo Xu, Andrew MacIsaac
Jul 31, 2014·Pharmacotherapy·Poojita ShivamurthyMichael L Therrien
Jan 13, 2015·International Journal of Cardiology·Daniel CaldeiraJoão Costa
Mar 6, 2018·Basic & Clinical Pharmacology & Toxicology·David E MoodyWenfang B Fang

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Citations

Nov 21, 2019·The Annals of Pharmacotherapy·Nicholas C Schwier, Katherine O'Neal

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