Mohammadi Keyhan, Ansari Ramin, Yaribash Shakila
Department of Clinical Pharmacy, Faculty of Pharmacy Tehran University of Medical Sciences Tehran Iran.
Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran Iran.
Clin Case Rep. 2024 Jul 23;12(8):e9213. doi: 10.1002/ccr3.9213. eCollection 2024 Aug.
The precise management of hypersensitivity reactions to direct oral anticoagulants (DOACs) and the potential for cross-reactivity among different DOACs remain unclear. In such cases, switching between DOACs may be feasible and could be considered, but close monitoring for adverse effects is essential, tailored to individual patient responses and tolerability.
Hypersensitivity reactions to DOACs, though considered rare, have been documented. This report describes the case of a 28-year-old male with a history of testicular cancer who was recently diagnosed with deep vein thrombosis. He was referred to an outpatient pharmacotherapy clinic due to suspected rivaroxaban-induced cutaneous reactions. Following a thorough evaluation, his anticoagulant therapy was switched from rivaroxaban to apixaban. This change was successfully implemented, and no hypersensitivity symptoms recurred during subsequent follow-up. This case demonstrates the importance of recognizing potential adverse reactions to DOACs and illustrates the feasibility of switching anticoagulants under close medical supervision to ensure patient safety and effective treatment.
直接口服抗凝剂（DOACs）过敏反应的精确管理以及不同DOACs之间交叉反应的可能性仍不明确。在此类情况下，在不同DOACs之间切换可能可行且可予以考虑，但根据个体患者的反应和耐受性进行密切的不良反应监测至关重要。
尽管对DOACs的过敏反应被认为罕见，但已有相关记录。本报告描述了一名28岁患有睾丸癌病史的男性病例，该患者近期被诊断为深静脉血栓形成。由于怀疑利伐沙班引起皮肤反应，他被转诊至门诊药物治疗诊所。经过全面评估，其抗凝治疗从利伐沙班转换为阿哌沙班。这一转换成功实施，且在后续随访期间未再出现过敏症状。该病例证明了认识到DOACs潜在不良反应的重要性，并说明了在密切医疗监督下切换抗凝剂以确保患者安全和有效治疗的可行性。
