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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Case Report

A Rare Case Report of Dabigatran Induced Oral Ulcers

Author(s): Ajeet Singh*, Neel Prabha and Hitesh Yadav

Volume 15, Issue 2, 2020

Page: [160 - 162] Pages: 3

DOI: 10.2174/1574886315666200212093453

Price: $65

Abstract

Background: Dabigatran is a novel oral anticoagulant molecule which is a direct thrombin (Factor IIa) inhibitor and is used for prevention of stroke and systemic embolism. It is easy to administer as compared to warfarin therapy as it does not require routine laboratory monitoring and has fewer drug interactions.

Objective: To present a rare case of oral ulcers secondary to dabigatran in a patient with deep vein thrombosis.

Case Report: A 68-year-old female presented with painful oral ulcers, retrosternal pain and difficulty in swallowing. She had been taking capsule Dabigatran for the prevention of systemic embolism for 2 months. She had experienced symptoms of onset taking dabigatran for 7 days. Clinical examination revealed three tender, well-defined, clean looking ulcers of various sizes present over the dorsum of the tongue. Dabigatran was withdrawn and the patient was on oral proton pump inhibitors. Patient showed remarkable improvement in oral ulcers after 2 weeks.

Conclusion: Patient education and counseling should be done regarding this side effect of dabigatran and proper intake of this medicine.

Keywords: Oral ulceration, dabigatran, oral anticoagulant, adverse drug reaction, direct thrombin, AF.

Graphical Abstract
[1]
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014; 130(23): e199-267.
[http://dx.doi.org/10.1161/CIR.0000000000000041] [PMID: 24682347]
[2]
Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361(12): 1139-51.
[http://dx.doi.org/10.1056/NEJMoa0905561] [PMID: 19717844]
[3]
Singh S, Savage L, Klein M, et al. Severe necrotic oesophageal and gastric ulceration associated with dabigatran. BMJ Case Rep 2013; 2013bcr2013009139
[http://dx.doi.org/10.1136/bcr-2013-009139]
[4]
Okada M, Okada K. Exfoliative esophagitis and esophageal ulcer induced by dabigatranEndoscopy 2012. 44((Suppl 2 UCTN)): E23-4
[http://dx.doi.org/10.1055/s-0031-1291503]
[5]
Zimmer V, Casper M, Lammert F. Extensive dabigatran-induced exfoliative esophagitis harboring squamous cell carcinoma Endoscopy 2014. 46(Suppl 1 UCTN): E273-4
[http://dx.doi.org/10.1055/s-0034-1365782] [PMID: 24906097]
[6]
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30(2): 239-45.
[http://dx.doi.org/10.1038/clpt.1981.154] [PMID: 7249508]
[7]
Pradaxa (dabigatran). Copyright 2014 Boehringer Ingelheim Pharmaceuticals, Inc. Ridgefield, CT 06877 USA August 2014.
[8]
Highlights of prescribing information. Available from:. http://www. accessdata.fda.gov/drugsatfda_docs/label/2013/022512s017lbl.pdf

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