Thrombocytopenia induced by rivaroxaban
10.3760/cma.j.cn114015-20240412-00247
- VernacularTitle:利伐沙班致血小板减少
- Author:
Cunfei LIU
1
;
Wenqi LIU
;
Zhengrong LI
;
Zongfa ZHU
;
Yuxi WANG
;
Shouwen ZHANG
Author Information
1. 山东第二医科大学附属临沂市人民医院心血管内科，临沂 276003
- Publication Type:Journal Article
- Keywords:
Thrombocytopenia;
Rivaroxaban;
Novel oral anticoagulant;
Adverse drug reactions
- From:
Adverse Drug Reactions Journal
2025;27(2):120-122
- CountryChina
- Language:Chinese
-
Abstract:
A 66-year-old female patient with multiple chronic diseases was on long-term treatment with digoxin, spironolactone, metoprolol, atorvastatin, dapagliflozin, and entecavir, with no abnormality platelet count (PLT). Due to hypertrophic obstructive cardiomyopathy and atrial fibrillation, digoxin was discontinued, and rivaroxaban 15 mg once daily orally was added to prevent thrombosis. Concurrently, furosemide, sacubitril valsartan, meglumine adenosine cyclophosphate, and silibinin was given for cardiac load reducement, blood pressure control and heart failure improvement, myocardial nutrition, and liver function improvement, respectively. After the initiation of this regimen, the patient′s PLT gradually decreased and was 51×10 9/L on day 13. Drug-induced thrombocytopenia was considered, with rivaroxaban being the likely causative agent. Rivaroxaban was then switched to warfarin, methylprednisolone 40 mg was administered intravenously once, and the remaining medications were continued. The patient′s PLT gradually increased. On day 11 after discontinuing rivaroxaban, the PLT was 155×10 9/L. At a 2-week follow-up, PLT of the patient was 169×10 9/L.
