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Isolated hemopericardium after initiation of rivaroxaban: Implications and potential mechanisms

By Adwait Mehta, David Burkland and Nilesh Mathuria


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

Topics: direct oral anticoagulants, rivaroxaban, pericardial effusion, Medicine (General), R5-920
Publisher: PAGEPress Publications
Year: 2019
DOI identifier: 10.4081/cp.2019.1096
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