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Related Experiment Video

Updated: Jul 4, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

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Accidental Rivaroxaban Intoxication in a 25-month-old Child Monitored by Thromboelastography: A Case Report.

Keita Nakanishi¹, Shota Yamasaki², Yuna Watanabe¹

¹Department of Pediatrics, Akashi Medical Hospital, Hyogo, Japan.

The Kobe Journal of Medical Sciences

|February 19, 2026

Summary

A child accidentally ingested a large dose of rivaroxaban. Thromboelastography (TEG® 6s) monitoring showed coagulation function normalized within 20 hours, indicating its usefulness in pediatric cases.

Keywords:

Factor Xa inhibitors Home accidents Novel oral anticoagulants Overdose TEG® 6s

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Area of Science:

Pediatric Emergency Medicine
Pharmacology
Clinical Coagulation

Background:

Rivaroxaban is a direct-acting factor Xa inhibitor.
Thromboelastography (TEG® 6s) assesses coagulation, often used perioperatively.
Limited data exists on TEG® 6s in pediatric rivaroxaban overdose.

Purpose of the Study:

To report a case of pediatric rivaroxaban ingestion.
To evaluate the utility of TEG® 6s in monitoring coagulation after overdose.
To assess the safety and recovery profile in a child.

Main Methods:

Case report of a 25-month-old girl with accidental rivaroxaban ingestion.
Continuous coagulation monitoring using TEG® 6s.
Clinical observation for bleeding events.

Main Results:

No apparent bleeding upon presentation.
TEG® 6s values normalized approximately 20 hours post-ingestion.
Patient discharged without complications or bleeding.

Conclusions:

TEG® 6s may be a valuable tool for monitoring rivaroxaban's effects in pediatric overdose.
Accidental large-dose rivaroxaban ingestion in children can be managed with close observation.
Normalization of coagulation parameters suggests recovery from anticoagulant effects.