Do you know what adverse reactions your medication might cause? Doctors might prescribe one of the newer anticoagulants such as rivaroxaban (Xarelto) without stressing that there are potentially deadly side effects. That was the tragic outcome for one of our readers.
Xarelto for Atrial Fibrillation:
Q. My husband was on Xarelto for about a year and a half because he had atrial fibrillation. When he had a hernia operation, he stopped taking it for three days but had major internal bleeding afterward. Despite this, his heart specialist continued the prescription.
One day he had some stomach pain and felt faint. We rushed him to the hospital, where he was diagnosed with a ruptured spleen. He had not fallen or bumped himself and there were no bruises on his body. The spleen was removed but the loss of blood could not be stopped because of the Xarelto.
He died one day later. Could the Xarelto have caused the spleen to rupture?
Xarelto Can Cause Severe Bleeding:
A. We are so sorry for your loss. The prescribing information for rivaroxaban (Xarelto) does not specifically mention the spleen, but bleeding into critical organs was reported during clinical trials.
This anticoagulant is prescribed for people with the abnormal heart rhythm atrial fibrillation. Xarelto should prevent blood clots from forming in the heart and being pumped into the circulation, especially the brain. That protection is important.
Patients must know, however, that this drug can cause dangerous hemorrhage, bleeding around the spinal column and certain blood disorders. Symptoms such as sudden fever, chills, sore throat, mouth ulcers and weakness in arms or legs require immediate medical attention. Excessive bruising or bleeding from cuts and scratches as well as blood in urine or stool also signal a dangerous reaction. Any patient with such symptoms while taking Xarelto should contact the doctor immediately.
What About Warfarin?
Warfarin (Coumadin) was once the drug of choice for atrial fibrillation, but the newer anticoagulants like Xarelto have been embraced by physicians. These more recent drugs don’t require careful monitoring as warfarin does. Indeed, it is not even possible. There is no good way to monitor how well rivaroxaban is working to prevent blood clotting, and physicians still have not worked out practical and quick ways to reverse it in the event of dangerous bleeding (Cardiovascular Therapeutics, April 2014).
Xarelto and other new anticoagulants don’t interact dangerously with foods as warfarin can. That is a selling point. With care, however, patients can avoid serious food-warfarin interactions. We list some of the foods and other drugs that are incompatible with warfarin in our free Guide to Coumadin Interactions.
Revised 1/23/2017
