Key result
Combining DOACs and P-gp inhibitors linked to potentially fatal pericardial effusion in three predisposed patients.
Why the study?
Pericardial effusion is a rare but potentially fatal adverse effect reported with direct oral anticoagulants combined with p-glycoprotein inhibitors or combined p-glycoprotein and CYP3A4 inhibitors.
Case Report (n=3)
No
Co-administration of DOACs and p-glycoprotein inhibitors may precipitate severe pericardial effusion in predisposed patients.
May warrant vigilance for pericardial effusion with DOAC plus P-gp inhibitor use; hypothesis-generating and requires confirmation.
Pericardial effusion is a rare but potentially fatal adverse effect reported with apixaban, dabigatran, edoxaban, and rivaroxaban (direct oral anticoagulants). We report three cases of pericardial effusion that occurred at a single institution with two patients requiring urgent pericardiocentesis. All patients took a direct oral anticoagulant with a p-glycoprotein inhibitor or a combined p-glycoprotein and CYP3A4 inhibitor. Our patients had underlying conditions predisposing them to developing pericardial effusion.
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Jered et al. (2025) conducted a case report in Pericardial effusion (n=3). Direct oral anticoagulants and P-glycoprotein inhibitors was evaluated on Development of pericardial effusion or hemopericardium. Concurrent use of direct oral anticoagulants and p-glycoprotein inhibitors was associated with rare but potentially fatal pericardial effusion in three patients with predisposing underlying conditions.
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