Xarelto Coupled with Digoxin Increases Risk of Death

When Duke University researchers assessed clinical trial data of patients prescribed digoxin (a drug used to treat congestive heart failure) along with anticoagulant Xarelto, they found that this drug coupling led to an increased risk of death in patients with atrial fibrillation (AF). The study, published in medical journal The Lancet on March 5, 2015, reviewed data collected from Xarelto’s ROCKET AF trial, which was used to support Xarelto’s approval by the FDA. 5,239 patients in the study (about 37% of total participants) were given digoxin for ventricular rate control, and researchers found a 17% increased risk in all-cause mortality, a 19% increased risk in vascular death, and a 36% increased risk in sudden death among patients given both drugs. While Xarelto has significant drawbacks on its own—having been linked to severe, and sometimes fatal, bleeding events to which there is no antidote—adding digoxin to a patient’s regiment provides an even greater risk of death than just taking Xarelto alone.

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