Gastrointestinal bleeding associated with rivaroxaban administration in a treated patient infected with human immunodeficiency virus.
The use of rivaroxaban in fixed dosing regimens without need for routine coagulation monitoring may lead to the misconception that there is a minimal risk of drug-drug interactions. We describe the case of a patient infected with human immunodeficiency virus (HIV) on salvage therapy who developed gastrointestinal bleeding while receiving the standard dose of rivaroxaban for the prevention of venous thromboembolism after surgery. This case clearly sends a warning that protease inhibitors should not be co-administered with rivaroxaban. Furthermore, it highlights the importance of clinicians' caution about potential drug-drug interactions.
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Switzerland.
Botond
B
Lakatos
Marcel
M
Stoeckle
Luigia
L
Elzi
Manuel
M
Battegay
Catia
C
Marzolini
D064386:Ankle Fractures; D000925:Anticoagulants / Q000009:adverse effects*; D000069454:Darunavir; D004347:Drug Interactions; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000009:adverse effects*; D019438:Ritonavir / Q000627:therapeutic use; D000069552:Rivaroxaban; D013449:Sulfonamides / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects*
D000925:Anticoagulants; D017320:HIV Protease Inhibitors; D009025:Morpholines; D013449:Sulfonamides; D013876:Thiophenes; D000069552:Rivaroxaban; D019438:Ritonavir; D000069454:Darunavir