Single Ingestions of Factor Xa Inhibitors Don't Appear to Cause Bleeding

The recently approved factor Xa inhibitors apixaban and rivaroxaban are rapidly replacing warfarin as the preferred anticoagulants in the treatment of thromboembolic disease and atrial fibrillation. Limited information has been published about their toxicity from ingestions by children and in suicide attempts. Investigators reviewed data from 8 regional poison control centers on reported ingestions of these agents from 2012 through 2014.

Of 223 ingestions, 20 were by children younger than 12 years; 12 were suicide attempts. Ingested doses ranged from 5 to 1200 mg for rivaroxaban and 2.5 to 20 mg for apixaban. Bleeding was reported in 15 patients (7%), all of whom were adults taking these medications chronically. The only intracranial hemorrh…