Major Bleeding After Paracentesis Associated With Apixaban Use: Two Case Reports. (February 2023)

• Record Type: Journal Article
• Authors: Kuperman, Ethan; Hobbs, Ryan A.
• Is Part Of: Hospital pharmacy. Volume 58:Number 1(2023)
• Page Start: 34
• Page End: 37
• Publication Date: 2023-02
• Subjects: anticoagulants -- adverse drug reactions -- gastrointestinal disorders -- medication safety; Hospital pharmacies -- Periodicals; Pharmacy Service, Hospital; Hospital pharmacies; Periodicals; Periodicals; 615.1
• DOI: 10.1177/00185787221111741
• Languages: English
• ISSNs: 0018-5787

Abstract

We report 2 patients with compensated cirrhosis and moderate renal impairment who experienced severe bleeding complications from paracentesis during concurrent therapy with apixaban. While paracentesis has traditionally been considered a low bleeding-risk procedure and safe to perform without interruption of therapeutic anticoagulation, the increased concentrations observed in patients with impaired liver function may place these patients at unexpectedly high bleeding risk. Further investigation into the safety of paracentesis in patients with cirrhosis on apixaban may be warranted, as well as additional understanding of the clinical safety of this drug in Child-Pugh B cirrhosis.