![]() Lessons:ĭespite the ingestion of a massive amount of rivaroxaban, the plasma levels were not as high as feared, due to the ceiling effect of rivaroxaban absorption. Outcomes:ĭespite the massive inhibition of the coagulation system, the patient did not experience bleeding apart from a slight gross hematuria. The phenprocoumon overdose was treated by the administration of vitamin K and PCC. The patient had ingested 1960 mg rivaroxaban, 31.5 mg phenprocoumon, 1425 mg diclofenac, and 21,000 mg metamizole in suicidal intention. ![]() We report the case of a patient with a massive mixed anticoagulant intoxication. Oral anticoagulants and painkillers, some with an additional effect on the coagulation system, are widely used and are therefore prone to abuse and (intentional) overdose. Received in revised form October 10, 2016 ![]() The work cannot be changed in any way or used commercially without permission from the journal. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The authors declare that they have no conflicts of interest relevant to the manuscript. 12, D-91054 Erlangen, Germany (e-mail: ).Ībbreviations: ALT = alanine aminotransferase, aPTT = activated partial thromboplastin time, INR = international normalized ratio, LDH = lactate dehydrogenase, PCC = prothrombin complex concentrate, PT = prothrombin time. ATransfusion Medicine and Hemostaseology DepartmentĬDepartment of Forensic Medicine, University Hospital Erlangen, Erlangen, Germany.Ĭorrespondence: Hella Pfeiffer, Transfusion Medicine and Hemostaseology Department, University Hospital Erlangen, Krankenhausstr.
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