The Drug-Induced Respiratory Disease Website

Rivaroxaban

Hemopericardium - Bloody pericardial effusion

Large effusions can cause cardiac tamponade. May occur late into treatment with anticoagulants

Jain V, Abou Hassan OK, Chetrit M, Bansal A, Gad MM, Kassis N, Klein AL

A Complicated Case of Transient Constrictive Pericarditis Secondary to Rivaroxaban-Associated Hemopericardium.

JACC. Case reports 2020 Oct;2;1947-1950 — 2020 Oct — 1947-1950

Kham NM, Song M

Spontaneous, Life-Threatening Hemorrhagic Cardiac Tamponade Secondary to Rivaroxaban.

American journal of therapeutics 2016 Jul-Aug;23;e1128-31 — 2016 Jul-Aug — e1128-31

Shivamurthy P, Brar N, Therrien ML

Isolated hemopericardium associated with rivaroxaban: first case report.

Pharmacotherapy 2014 Sep;34;e169-72 — 2014 Sep — e169-72

Xu B, MacIsaac A

Life-threatening haemorrhagic pericarditis associated with rivaroxaban.

International journal of cardiology 2014 Jun 15;174;e75-6 — 2014 Jun 15 — e75-6

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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