Adding Herbal Products to Direct-Acting Oral Anticoagulants Can Be Fatal

  • Ossama Maadarani Internal Medicine Department, Ahmadi Hospital- Kuwait Oil Company, Al Ahmadi, Kuwait
  • Zouhair Bitar Internal Medicine Department, Ahmadi Hospital- Kuwait Oil Company, Al Ahmadi, Kuwait
  • Mohammad Mohsen Internal Medicine Department, Ahmadi Hospital- Kuwait Oil Company, Al Ahmadi, Kuwait

Keywords

Ginger, cinnamon, dabigatran

Abstract

Direct-acting oral anticoagulants (DOACs) are used to prevent and treat systemic and cerebral embolisms in patients with non-valvular atrial fibrillation (NV-AF). The use of DOACs with herbal products without consulting healthcare professionals increases the possibility of drug–herb interactions and their adverse effects. An 80-year-old man on dabigatran with a known history of NV-AF presented with a 1-day history of haematemesis and black stool which began 3 days after he had started taking a boiled mixture of ginger and cinnamon. The patient was hypotensive and treated as a case of gastrointestinal bleeding and haemorrhagic shock. Despite continuous aggressive resuscitation measures including administration of a reversal agent for dabigatran, we were unable to control bleeding and the patient died within 24 hours. The interaction of ginger and cinnamon with dabigatran led to fatal bleeding.

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  • Published: 2019-07-19

    Issue: Vol 6 No 8 (view)

    Section: Articles

    How to cite:
    Maadarani, O., Bitar, Z., & Mohsen, M. (2019). Adding Herbal Products to Direct-Acting Oral Anticoagulants Can Be Fatal. European Journal of Case Reports in Internal Medicine, 6(8). https://doi.org/https://doi.org/10.12890/2019_001190