From the Research
Allergy to Eliquis (Apixaban) and Use of Xarelto (Rivaroxaban)
- There is limited evidence on the cross-reactivity between Eliquis (apixaban) and Xarelto (rivaroxaban) 1, 2, 3.
- A case report describes a patient who experienced a hypersensitivity reaction to rivaroxaban and was successfully switched to apixaban, suggesting that cross-reactivity may not always occur 2.
- Another case report describes a patient who experienced a lichenoid eruption due to apixaban, but tolerated rivaroxaban, further suggesting that cross-reactivity may not always occur 3.
- However, it is essential to note that hypersensitivity reactions to direct oral anticoagulants (DOACs) are rare and can be challenging to predict 1, 2, 3.
- If a patient is allergic to Eliquis (apixaban), it is crucial to exercise caution when considering the use of Xarelto (rivaroxaban) and to monitor the patient closely for any signs of hypersensitivity reactions 2, 3.
Key Considerations
- The management of hypersensitivity reactions to DOACs requires careful adherence to first principles of bleeding care, and unapproved and untested reversal strategies may be required in patients with life-threatening bleeding 4.
- Close monitoring for adverse effects is essential when switching between DOACs, tailored to individual patient responses and tolerability 2.
- Recognizing potential adverse reactions to DOACs and switching anticoagulants under close medical supervision can ensure patient safety and effective treatment 2, 3.