Unmasking Bladder Cancer: A Case of Macrohematuria during Rivaroxaban Therapy | Chapter 5 | Medical Science: Trends and Innovations Vol. 7

Background: Bladder cancer is the tenth most common cancer worldwide and the most common cancer of the urinary tract. Rivaroxaban is a directly acting, oral anti-coagulant (factor Xa inhibitor) that is used to treat and prevent the formation of blood clots. A common side effect of this drug is an increase in bleeding tendencies, which can potentially lead to macroscopic hematuria. However, it is important to note that macroscopic hematuria can appear in several other conditions including urological malignancies.

Objective: This report outlines the case of a patient on long term rivaroxaban therapy who developed macroscopic hematuria, not as a consequence of the medication but rather due to bladder cancer.

The Case: This study reports a case of a 69-year-old male patient with a history of myocardial infarction undergoing long term Rivaroxaban therapy, presenting with macroscopic hematuria and frequent urination. The clinical history and presenting symptoms were consistent with the side effects of prolonged use of Rivaroxaban, but further investigations revealed the presence of a tumor in the bladder which was instead found to be the cause of macroscopic hematuria.

Conclusion: Although macroscopic hematuria is a very common side effect of Rivaroxaban therapy, it is vital to consider other conditions that can present with the same symptoms. This case shows the need for healthcare practitioners to be more vigilant when handling patients with anti-coagulant induced hematuria and the importance of thoroughly examining every patient before coming to a conclusive diagnosis.

 

Author (s) Details

 

Suha Al Fathima Mohamed Al Sabry
Department of Internal Medicine I, Grodno State Medical University, Grodno, Republic of Belarus.

 

Gamage Ravindi Lakma Perera
Department of Internal Medicine I, Grodno State Medical University, Grodno, Republic of Belarus.

 

Balapuwaduge Shayami Michelle Mendis
Department of Internal Medicine I, Grodno State Medical University, Grodno, Republic of Belarus.

 

Karpovich Yulia Ivanovna
Department of Internal Medicine I, Grodno State Medical University, Grodno, Republic of Belarus.

 

Karpovich Yuri Leonidovich
Department of Internal Medicine I, Grodno State Medical University, Grodno, Republic of Belarus.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/4357

Design, Development and Evaluation of Rivaroxaban Oral Films for Optimized Drug Delivery | Chapter 5 | Pharmaceutical Science: New Insights and Developments Vol. 2

The COVID-19 pandemic has heightened the risk of thrombotic events, both microvascular and macrovascular, due to a hypercoagulable state triggered by inflammatory responses, endothelial dysfunction, and platelet activation in infected individuals. As a result, anticoagulants like Rivaroxaban (RN), a direct oral anticoagulant (DOAC) that inhibits Factor Xa and prevents clot formation, have been crucial in mitigating thrombotic risks. Rivaroxaban is commonly used in the treatment of venous thromboembolism, including deep vein thrombosis (DVT), and arterial thrombotic diseases like coronary artery disease (CAD) and peripheral artery disease (PAD). However, conventional tablet forms pose challenges for patients with dysphagia or difficulty swallowing, necessitating alternative drug delivery methods. This study aimed to develop fast-disintegrating Oral Thin Films (OTFs) of Rivaroxaban to address these challenges by improving bioavailability, enhancing patient compliance, and ensuring rapid drug release. OTFs dissolve quickly in saliva, making them ideal for patients with swallowing difficulties. Using the solvent casting method, the formulation incorporated super-disintegrants to ensure rapid disintegration and enhanced drug release. A2^² factorial design using Design-Expert® software has optimized critical formulation parameters such as super-disintegrant concentration and polymer composition. The optimized OTF exhibited rapid disintegration, with a cumulative drug release of 93.47% within 60 seconds. Short-term stability studies confirmed the formulations' integrity under storage conditions. In vitro drug release followed first-order kinetics was primarily governed by Fickian diffusion, ensuring predictable drug delivery. The study demonstrates that Rivaroxaban OTFs offer a promising alternative to conventional dosage forms, improving bioavailability and patient adherence, particularly for those with swallowing difficulties or requiring rapid drug action. This innovative drug delivery system represents a significant advancement in anticoagulant therapy, with the potential for enhanced therapeutic outcomes.

 

Author (s) Details

Rama Rao Nadendla
Department of Pharmaceutics, Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur - 522034, Andhra Pradesh, India.

 

Sandeep Kanna
Department of Pharmaceutics, Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur - 522034, Andhra Pradesh, India.

 

Juluri Satyanarayan
Department of Pharmaceutics, Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur - 522034, Andhra Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/psnid/v2/4152

Studies on Compatibilty of Rivaroxaban with Pharmaceutical Excipients Using DSC and FTIR Spectrophotometry | Chapter 10 | Challenges and Advances in Pharmaceutical Research Vol. 4

A potent oral anticoagulant, rivaroxaban (RN), was just recently created. It was the medication that was most frequently administered during the COVID-19 epidemic. This study aims to explore the compatibility of rivaroxaban with crospovidone, sodium starch glycolate, magnesium stearate, talc, microcrystalline cellulose, aerosil, HPMC K100 M, and croscarmellose sodium using a differential scanning calorimeter and an FTIR spectrophotometer. According to DSC thermograms of rivaroxaban and a physical combination of several pharmaceutical excipients, the drug transition temperature ranged from 224°C to 232°C. The FTIR plots showed that all of the chosen pharmaceutical excipients had wave numbers that matched to rivaroxaban. The DSC and FTIR analyses revealed that RN was not interfering with the selected pharmaceutical excipients and that it may be employed in future studies. According to the investigation's findings, these combinations are safe and can be employed in future research to create rivaroxaban-containing pharmaceutical formulations.

Author (s) Details:

Rama Rao Nadendla,
Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur, Andhra Pradesh, India.

J. Satynarayana,
Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur, Andhra Pradesh, India.

Jaya Krishna Burri,
Chalapathi Institute of Pharmaceutical Sciences, Chalapathi Nagar, Lam, Guntur, Andhra Pradesh, India.

Please see the link here: https://stm.bookpi.org/CAPR-V4/article/view/7512

Development of a Discriminatory Drug Dissolution Method for Estimation of Rivaroxaban from Rivaroxaban Tablets | Chapter 9 | Current Aspects in Pharmaceutical Research and Development Vol. 2

 The purpose of this study is to develop a discriminate dissolving method that may be utilised as a release parameter for testing and assessing product performance in regulated markets utilising quality by design trials. Dissolution testing is required for all solid oral dosage forms and is utilised for product release and stability testing throughout the development life cycle. The proper parameters were developed after testing solubility in the dissolution medium, surfactant concentration, rotation speed, dissolution medium pH, and apparatus type. The best dissolution conditions were found using a USP apparatus II, 900 ml of 0.4 percent SLS medium in pH 4.5 acetate buffer, and a 75 rpm rotation speed, according to research. Conclusion: This study demonstrates the methodical development of a discriminate dissolution method for Rivaroxaban, a BCS Class 2 medication with pH-independent solubility. The dissolution method described here can be used to perform a quality control test on Rivaroxaban tablets, with an emphasis on batch to batch comparisons.

Author(s) Details        

Pankaj Mandpe
Micro Labs Ltd., Andheri (E), Mumbai, India.

View Book :- https://stm.bookpi.org/CAPRD-V2/article/view/3957