Monitoring the anticoagulant effect after a massive rivaroxaban overdose

J Thromb Haemost. 2014 Sep;12(9):1570-1. doi: 10.1111/jth.12669. Epub 2014 Aug 11.

Abstract

Rivaroxaban is a direct factor Xa inhibitor approved for prevention of stroke, prevention and treatment of venous thromboembolism and secondary prevention of acute coronary syndrome in many countries. As the use of this agent increases, so does the potential for overdose, both intentional and unintentional. Clinical data on overdoses of rivaroxaban in humans are limited. We report the case of a 42-year-old man who took an overdose of 1400 mg of rivaroxaban and describe how resolution of the anticoagulant effect was monitored using readily available coagulation assays.

Keywords: anticoagulant drugs; blood coagulation tests; drug toxicity; factor Xa; rivaroxaban.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / toxicity*
  • Blood Coagulation / drug effects
  • Blood Coagulation Factors / administration & dosage
  • Blood Coagulation Tests / methods*
  • Drug Monitoring / methods*
  • Drug Overdose*
  • Factor Xa / chemistry*
  • Humans
  • International Normalized Ratio
  • Male
  • Morpholines / toxicity*
  • Prothrombin Time
  • Rivaroxaban
  • Thiophenes / toxicity*
  • Thromboembolism / complications
  • Thromboembolism / drug therapy
  • Tranexamic Acid / administration & dosage
  • Treatment Outcome

Substances

  • Anticoagulants
  • Blood Coagulation Factors
  • Morpholines
  • Thiophenes
  • prothrombin complex concentrates
  • Tranexamic Acid
  • Rivaroxaban
  • Factor Xa