Warfarin-induced purple toe syndrome successfully treated with apixaban

Cakebread, Holly E; Knight, Hui Min; Gajendragadkar, Parag R; Cooper, John

doi:10.1136/bcr-2014-205320

Cited by 6 publications

(6 citation statements)

References 4 publications

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“…44 Patients with WIPTS who require long-term anticoagulation should be switched to FXa inhibitors such as fondaparinux or apixaban. 44,47…”

Section: Drug Reactions To Warfarinmentioning

confidence: 99%

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Gooderham

2017

J Cutan Med Surg

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Anticoagulants are amongst the most commonly prescribed medications worldwide. Although rare, localised and systemic drug reactions have been reported with anticoagulants that can lead to significant morbidity and mortality. Some of the first signs of drug reactions to anticoagulants are cutaneous changes that, when recognised early, can prevent significant complications. Dermatologists should be aware of these changes to make an early and accurate diagnosis. This is particularly important in instances of skin-induced necrosis caused by systemic toxicity to anticoagulants. This review discusses adverse drug reactions to the traditional anticoagulants, warfarin and heparin, and the newer direct oral anticoagulants (DOACs) such as the thrombin inhibitor, dabigatran, and the factor Xa inhibitors, rivaroxaban, apixaban, and edoxaban. In particular, this review provides dermatologists with a framework for early diagnosis and management of patients with drug reactions to anticoagulants and alerts them to potential bleeding complications associated with minor procedures.

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“…44 Patients with WIPTS who require long-term anticoagulation should be switched to FXa inhibitors such as fondaparinux or apixaban. 44,47…”

Section: Drug Reactions To Warfarinmentioning

confidence: 99%

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Gooderham

2017

J Cutan Med Surg

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“…Two case reports suggest that warfarin-induced CCE can be successfully treated using Xa inhibitors; with fondaparinux in one case ( 5 ) and with apixaban in the other ( 6 ). In these reports, it was noted that warfarin had a direct toxic effect on the capillaries, resulting in vasodilation and increased permeability ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although warfarin is the most common causative anticoagulant, there are no case reports suggesting that any factor Xa inhibitor can cause CCE. There are two case reports in which Xa inhibitors were substituted for warfarin and achieved a complete resolution of CCE ( 5 , 6 ). It is unclear why Xa inhibitors may be a useful treatment for CCE, and not a cause.…”

Section: Introductionmentioning

confidence: 99%

Cholesterol Crystal Embolism Induced by Direct Factor Xa Inhibitor: A First Case Report

et al. 2018

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Abstract:An 80-year-old man presented at our hospital with renal failure. He had been treated with edoxaban, an oral direct factor Xa inhibitor, for deep vein thrombosis for 10 months prior to admission. Although the pulses in his bilateral pedal arteries were palpable, cyanosis was present in the bilateral toes. Laboratory data indicated azotemia and eosinophilia. A skin biopsy confirmed a diagnosis of cholesterol crystal embolism (CCE). Because no invasive vascular procedure was performed, we assumed that CCE was related to edoxaban. To the best of our knowledge, this is the first case report suggesting CCE induced by an Xa inhibitor.

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“…It can be reversed when it is discovered early and when warfarin is discontinued. Otherwise, it may lead to gangrene necessitating amputation [5,[11][12][13].…”

Section: Adverse Effectsmentioning

confidence: 99%

Pharmacological Review of Anticoagulants

Tsai¹

2020

Anticoagulation Drugs - The Current State of the Art

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The art and science of anticoagulation have never gotten more complicated than it has now. Newer anticoagulants have entered the market and have provided more options to the patients and healthcare professionals. This chapter will review the basic physiology of hemostasis, pharmacology of the anticoagulants, and how these medications are used in the clinical setting. The mechanism of action, pharmacokinetics and pharmacodynamics, clinical evidence of use and clinical pearls, laboratory monitoring in clinical practice, and adverse effects will be examined individually for each drug considered. This chapter will serve as a review for the practicing clinician and a thorough introduction for the beginning reader.

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Warfarin-induced purple toe syndrome successfully treated with apixaban

Cited by 6 publications

References 4 publications

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Adverse Drug Reactions and Cutaneous Manifestations Associated With Anticoagulation

Cholesterol Crystal Embolism Induced by Direct Factor Xa Inhibitor: A First Case Report

Pharmacological Review of Anticoagulants

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