Maadarani Ossama, Bitar Zouhair, Mohsen Mohammad
Internal Medicine Department, Ahmadi Hospital-Kuwait Oil Company, Al Ahmadi, Kuwait.
Eur J Case Rep Intern Med. 2019 Jul 19;6(8):001190. doi: 10.12890/2019_001190. eCollection 2019.
Direct-acting oral anticoagulants (DOACs) are used to prevent and treat systemic and cerebral embolisms in patients with non-valvular atrial fibrillation (NV-AF). The use of DOACs with herbal products without consulting healthcare professionals increases the possibility of drug-herb interactions and their adverse effects. An 80-year-old man on dabigatran with a known history of NV-AF presented with a 1-day history of haematemesis and black stool which began 3 days after he had started taking a boiled mixture of ginger and cinnamon. The patient was hypotensive and treated as a case of gastrointestinal bleeding and haemorrhagic shock. Despite continuous aggressive resuscitation measures including administration of a reversal agent for dabigatran, we were unable to control bleeding and the patient died within 24 hours. The interaction of ginger and cinnamon with dabigatran led to fatal bleeding.
Direct-acting oral anticoagulants (DOACs) are frequently prescribed for patients with non-valvular atrial fibrillation.Combining herbal products (ginger and cinnamon) with DOACs can be fatal.Physicians should alert patients and caregivers about dangerous combinations and interactions.
直接口服抗凝剂（DOACs）用于预防和治疗非瓣膜性心房颤动（NV-AF）患者的全身性和脑栓塞。在未咨询医疗保健专业人员的情况下将DOACs与草药产品一起使用会增加药物与草药相互作用及其不良反应的可能性。一名80岁服用达比加群且有NV-AF病史的男性，在开始服用生姜和肉桂煮的混合物3天后出现了1天的呕血和黑便病史。患者血压过低，被当作胃肠道出血和失血性休克病例进行治疗。尽管采取了包括使用达比加群逆转剂在内的持续积极复苏措施，但我们仍无法控制出血，患者在24小时内死亡。生姜和肉桂与达比加群的相互作用导致了致命性出血。
直接口服抗凝剂（DOACs）常用于非瓣膜性心房颤动患者。将草药产品（生姜和肉桂）与DOACs联合使用可能是致命的。医生应提醒患者及其护理人员注意危险的组合和相互作用。
