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Anti-factor Xa Monitoring and Activated Charcoal for a Pediatric Patient With Rivaroxaban Overdose
Brendan M Carr1, David J Roy1,2, Stacey A Bangh3,4
1Mayo Clinic, Department of Emergency Medicine, Rochester, Minnesota.
Clinical Practice and Cases in Emergency Medicine
|August 8, 2018
Summary
A child ingested a large dose of rivaroxaban, an anticoagulant. Activated charcoal and monitoring showed no adverse effects, but the impact of activated charcoal remains unclear.
Area of Science:
- Pharmacology
- Toxicology
- Pediatrics
Background:
- Rivaroxaban is an oral anticoagulant targeting factor Xa (FXa).
- Accidental ingestion of anticoagulants in children can pose risks.
- Monitoring plasma anti-FXa levels is crucial in cases of overdose.
Observation:
- A 35-month-old boy ingested 200 mg of rivaroxaban (16 mg/kg).
- Activated charcoal was administered shortly after ingestion.
- The patient underwent clinical observation and plasma anti-FXa level monitoring.
Findings:
- No serious adverse effects were reported during the hospital observation.
- This case represents the first reported use of anti-FXa monitoring following rivaroxaban ingestion.
- The specific contribution of activated charcoal to the outcome is uncertain.
Implications:
- This case highlights the importance of monitoring anti-FXa levels in pediatric rivaroxaban overdose.
- Further research is needed to clarify the efficacy of activated charcoal in such scenarios.
- Clinical vigilance and prompt management are key in pediatric anticoagulant ingestions.
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