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Updated: Feb 24, 2026
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Probable Rivaroxaban-Induced Full Body Rash: A Case Report
Evan Sasson1, Marian James1, Mark Russell2
11 Department of Pharmacy, Kingsbrook Jewish Medical Center, Brooklyn, New York, NY, USA.
Journal of Pharmacy Practice
|August 15, 2017
Summary
This case study highlights a probable rivaroxaban-induced rash in a patient with atrial fibrillation. The rash resolved upon switching to apixaban, suggesting a drug-specific reaction.
Area of Science:
- Pharmacology
- Dermatology
- Cardiology
Background:
- Rivaroxaban is a direct factor Xa inhibitor used for anticoagulation.
- Stroke prevention in nonvalvular atrial fibrillation is a key indication for rivaroxaban.
- Adverse drug reactions, including cutaneous manifestations, require careful monitoring.
Observation:
- A 79-year-old female developed a rash days after initiating rivaroxaban for stroke prevention.
- The patient had no prior allergy history.
- The rash necessitated emergency department admission and treatment.
Findings:
- The patient's rash resolved after discontinuation of rivaroxaban.
- Switching to apixaban, another factor Xa inhibitor, resulted in no adverse events.
- This suggests a probable rivaroxaban-specific hypersensitivity reaction.
Implications:
- Prescribers should consider the potential for rivaroxaban-induced rash.
- Alternative anticoagulants like apixaban may be tolerated in patients experiencing such reactions.
- Further research into the mechanism of rivaroxaban-induced rash is warranted.
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