CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 November;178(11):905-6

DOI: 10.23736/S0393-3660.18.03984-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Is apixaban therapy really free from abdominal pain?

Federico PACEI ¹ ✉, Maria J. MESSINA ¹, Raffaele NARDONE ²

¹ Stroke Unit, Department of Neurology, San Donato Polyclinic and IRCCS, San Donato Milanese, Milan, Italy; ² Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria

We describe a case of an 86-year-old woman with atrial fibrillation in her history with INR control borderline. The patient was admitted to our stroke unit for a ischemic cerebrovascular event. In consideration of the non-optimal INR control we decided to start apixaban therapy. After few hours the patient started to complain of abdominal pain. After many clinical and instrumental investigation we suspected apixaban as the probable cause of the abdominal pain. So the therapy was discontinued and the patient’s symptoms completely resolved. In the medicine leaflet there is not any reporting about abdominal pain as single symptoms. In fact gastrointestinal symptoms reported in the leaflet are: hematochezia, nausea, gastrointestinal hemorrhage, hemorrhoid hemorrhage, mouth bleeding, rectal hemorrhage, gum bleeding, retroperitoneal hemorrhage. Even in medical literature there are no any reports about this side effect. We think that is important to report any new side effects and to bring this new information to colleagues.

KEY WORDS: Apixaban; Abdominal pain; Adverse effects