Unexpected course of anti Xa activity after suicidal ingestion of rivaroxaban in an elderly patient

Česká verzia

Authors: Hana Matějovská Kubešová ¹; Ondřej Výška ¹; Miroslav Penka ²; Ondřej Ludka ¹
Authors place of work: Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno ¹; Interní hematologická a onkologická klinika LF MU a FN Brno ²
Published in the journal: Geriatrie a Gerontologie 2022, 11, č. 2: 95-98
Category:

Summary

The authors present a description of the course of a suicidal attempt in an elderly patient with mixed medication, including up to 12 tablets of rivaroxaban with a strength of 20 mg. Monitoring of anti-Xa activity showed its delayed onset compared to the manufacturer‘s data and clinical experience to date. The discussion considers the potential to influence the pharmacokinetics and pharmacodynamics of rivaroxaban with other medications and ethanol used concomitantly.

Keywords:

pharmacodynamics – rivaroxaban – anti Xa – suicidal attempt

Zdroje

1. Penka M. Rivaroxaban a inhibitory faktoru Xa v klinické praxi. Vnitř Lék 2010; 56(9): 920–926.

2. SÚKL. Souhrn údajů o přípravku.

3. Mueck W, Stampfus J, Kubitza D, Becka M. Clinical Pharmacokinetic and Pharmacodynamic Profile of Rivaroxaban. Clin Pharmacokinet (2014); 53: 1–16.

4. Kvasnička T, Malikova I, Zenahlíková Z, et al. Rivaroxaban: Metabolism, Pharmacologic Properties and Drug Interactions. Curr Drug Metab 2017; 18(7): 636–642.

5. Turpie AG. Oral, direct factor Xa inhibitors in development for the prevention and treatment of thrombembolic diseases. Arterioscler Thromb Vasc Biol 2007; 27: 1238–1247.

6. Finch A, Pillans P. P-glycoprotein and its role in drug-drug interactions. Australian prescribers 2014; 37(4): 137–139.

7. Jakowenko N, Nguyen S, Ruegger M, et al. Apixaban and rivaroxaban anti-Xa level utilization and associated bleeding events within an academic health system. Thrombosis Res 2020; 196: 276–282.

8. Kong L, Song Ch, Ye l, et al. The Effect of Vinpocetine on Human Cytochrome P450 Isoenzymes by Using a Cocktail Method. Evidence- Based Complementary and Alternative Medicine Volume 2016; Article ID 5017135.

9. Zhang Y, Li J, Yan Ch. An update on Vinpocetine: New discoveries and clinical implications. Eur J Pharmacol 2018; 819: 30–34.

10. Moore KT, Plotnikov AN, Thyssen A, et al. Effect of multiple doses of omeprazole on the pharmacokinetics, pharmacodynamics, and safety of a single dose of rivaroxaban. J Cardiovasc Pharmacol 2011; 58(6): 581– 588.

11. SÚKL. Souhrn údajů o přípravku.

12. Guengerich FP, Avadhani NG. Roles of Cytochrome P450 in Metabolism of Ethanol and Carcinogens. Adv Exp Med Biol 2018; 1032: 15–35.