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April 3, 2026BMJ Case Reports0 citations

Apixaban-induced anaphylaxis

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JPJessica Hyunji ParkBSBrett James SchuchardtCHChe Mathew Harris

Key Result

Apixaban ingestion caused a severe anaphylactic reaction, including dyspnoea, hypoxia, hypotension, and an urticarial rash, within an hour in a patient with deep vein thrombosis.

Key Points

  • To report a case of anaphylaxis induced by apixaban and highlight its importance as a rare side effect.
  • Case report of a patient with deep vein thrombosis treated with apixaban
  • Monitoring of symptoms after drug ingestion
  • Assessment of tryptase levels and clinical response to treatment
  • Patient experienced severe allergic reaction including dyspnoea and hypotension after taking apixaban
  • Elevated tryptase level confirmed anaphylactic reaction
  • Patient transitioned to enoxaparin and discharged the following day

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
1 female patient in her 60s presenting with left leg swelling and diagnosed with bilateral deep vein thrombosis.
I
Intervention
Apixaban (therapeutically indicated dose)
O
Outcome
Anaphylaxis (dyspnoea, hypoxia, hypotension, urticarial rash, and elevated tryptase level)safety

Apixaban can cause rare but potentially fatal anaphylaxis, highlighting the need for healthcare providers to recognize and promptly treat this adverse effect.

Abstract

Anaphylaxis is a rarely reported yet potentially fatal adverse effect of apixaban. This case involves a patient in her 60s who presented with left leg swelling and was diagnosed with bilateral deep vein thrombosis. Less than an hour after ingestion of therapeutically indicated apixaban, she experienced dyspnoea, hypoxia, hypotension and an urticarial rash. She was promptly treated with epinephrine, diphenhydramine and methylprednisolone and found to have an elevated tryptase level, a reliable marker for anaphylactic reactions. She clinically improved, transitioned to enoxaparin and was discharged the following day. This case encourages healthcare providers to consider anaphylaxis as a rare but potentially lethal side effect of apixaban.

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Cite This Study

Park et al. (2026) conducted a case report in Bilateral deep vein thrombosis (n=1). Apixaban was evaluated on Anaphylaxis. Apixaban ingestion caused a severe anaphylactic reaction, including dyspnoea, hypoxia, hypotension, and an urticarial rash, within an hour in a patient with deep vein thrombosis.

synapsesocial.com/papers/69cf5cd15a333a821460a641https://doi.org/10.1136/bcr-2026-272624
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Biphasic anaphylaxis: A review of the literature and implications for emergency management2018 · 62 citations
  2. 2Second symposium on the definition and management of anaphylaxis: Summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium2006 · 2,312 citations
  3. 3Non–IgE-mediated anaphylaxis2021 · 114 citations
  4. 4Emerging Causes of Drug-Induced Anaphylaxis: A Review of Anaphylaxis-Associated Reports in the FDA Adverse Event Reporting System (FAERS)2020 · 225 citations
  5. 5Oral Anticoagulant Utilization in the United States and United Kingdom2020 · 79 citations