The Drug-Induced Respiratory Disease Website

Apixaban

Hemopericardium - Bloody pericardial effusion

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

Ambat J, Patel S, Pathak PR, Antony M, Basu AK, Sto Domingo FG, Vu PQ

Apixaban-Induced Spontaneous Hemorrhagic Cardiac Tamponade.

Cureus 2024 Mar;16;e55476 — 2024 Mar — e55476

Aguilar-Gallardo JS, Das S, Reddy P, Mahmood K, Fox A

Clinically Ambiguous Hemorrhagic Cardiac Tamponade Associated with Apixaban.

Cureus 2022 Apr;14;e24290 — 2022 Apr — e24290

Cinelli M, Uddin A, Duka I, Soomro A, Tamburrino F, Ghavami F, Lafferty J

Spontaneous Hemorrhagic Pericardial and Pleural Effusion in a Patient Receiving Apixaban.

Cardiology research 2019 Aug;10;249-252 — 2019 Aug — 249-252

Asad ZUA, Ijaz SH, Chaudhary AMD, Khan SU, Pakala A

Hemorrhagic cardiac tamponade associated with Apixaban: A case report and systematic review of literature.

Cardiovascular revascularization medicine : including molecular interventions 2019 Apr 04;; — 2019 Apr 04

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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