Journal of Asthma and Allergy (Oct 2023)
Suspected Rivaroxaban-Induced Anaphylaxis Secondary to Ingestion of Rivaroxaban and Nimesulide Without Cross-Reactivity to Dabigatran – A Case Report
Abstract
Gediminas Gumbis,1 Inga Česnavičiūtė,1 Gabija Didžiokaitė,1,2 Daiva Gegeckienė,3 Violeta Kvedarienė4,5 1Faculty of Medicine, Vilnius University, Vilnius, Lithuania; 2Institute of Clinical Medicine, Faculty of Medicine, Vilnius University Clinic of Obstetrics and Gynaecology, Vilnius University, Vilnius, Lithuania; 3Centre of Cardiology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; 4Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; 5Centre of Innovative Allergology, Vilnius, LithuaniaCorrespondence: Gediminas Gumbis, Faculty of Medicine, Vilnius University, M. K. Čiurlionio g. 21, Vilnius, LT-03101, Lithuania, Tel +37060680714, Email [email protected]: Here, we describe a case of anaphylaxis secondary to rivaroxaban in a 61-year-old woman 24 hours after orthopedic surgery. 10– 15 minutes after ingestion of rivaroxaban and nimesulide, the patient’s palms started itching, her face and lips swelled, her face flushed, she developed shortness of breath and subsequently lost consciousness. Serum tryptase levels at the time of the anaphylactic reaction were elevated, with subsequent measurement one month later returning a value within the normal range. Dabigatran and meloxicam were identified as suitable alternative drugs by oral provocation at an allergy clinic. Even though rivaroxaban rarely causes serious allergic reactions, when prescribing it, it is important to analyze patients’ medical history for possible previously experienced drug-induced allergic reactions and to be aware of the risks of possible undesired drug interactions.Keywords: Xarelto, anticoagulant, DOAC, adverse drug reaction, allergy
