Can Xarelto cause hair loss and dry skin conditions?

A Blood Clot in the Heart - Photo by: ravindra gandhi- Source: Flickr Creative Commons

A Blood Clot in the Heart – Photo by: ravindra gandhi- Source: Flickr Creative Commons

Minor side effects such as hair loss and dry skin associated with Xarelto can ruin a patient’s quality of life even if they’re not included on the medication’s label. Everybody cares about its appearance, and many doctors and patients are complaining about these uncommon adverse reactions that Bayer never warned the public about.

Xarelto (Rivaroxaban) is a blood-thinner drug that recently raised several concerns because of its very serious side effects. The most alarming one are the internal bleedings that are often associated with this medication. Although almost all blood thinners do actually pose a risk for harmful bleeding accidents and internal hemorrhages, there’s no antidote available to reverse its anticoagulant effects. Even a minor accident like a gastrointestinal bleeding may lead to a patient’s death in particular instances (1).

Xarelto and its similar Pfizer’s counterpart Pradaxa (dabigatran), are also associated with other serious, and sometimes potentially deadly adverse reactions, such as an increased risk for stroke, thromboembolic events, and acute renal failure (2, 3). But what about the other minor, yet much more common issues that are often associated with this medication? Reading the full list of Xarelto side effects we found almost every imaginable ailment from diarrhea to fever, joint pain, red or yellow eyes, chills, abdominal pain and a lot more.

However, looking around blogs, patient’s stories and surveys, it seems that recently many people are suffering from two other discomforting conditions: hair loss and dry skin. Hair loss is not a known side effect of rivaroxaban or, at least, it’s not among those listed on its label. However, it could be associated with the reduction of blood reaching hair follicles, or as a consequence of the other adverse reaction, dry skin. Bleeding under the skin caused by the medication’s anticoagulant effect may cause the death of dermal cells, causing the skin to become brittle and dry.

Two recent studies found a correlation between the use of Novel Anticoagulants (NOACs) and hair loss (4, 5). In one of them, data from a large monocentric prospective NOAC registry was evaluated looking for newly reported cases of hair loss in 730 patients who received receiving dabigatran or rivaroxaban therapy. The results showed that 4.4% of total patients suffered from hair loss within three months since they started taking their prescription (5).

Looking for patient stories around the web, we a found patient describing how her hair started falling as soon as she started taking Xarelto as a prescription. She was even forced to wear a hair net while cooking. “My hair falls out so continuously that my poor husband and kids have found hair in our food before I realized that I had to take precautions while cooking!” she explained. Her response was written just below another patient’s opinion who described that he was “just about to shop for a wig or take classes on how to apply makeup like a movie star.” (6)

“My skin started itching like crazy all over for the first week” explained another patient in a popular website about adverse drug reactions, telling how he had to “coat entire body with shea butter day and night to treat the dry skin”.

Blistering, peeling, or loosening of the skin are included among this medication adverse reactions and are all signs of a general lack of control of the real blood-thinning power of this drug. One of the main selling points of this medication was the fact that it does require continuous blood monitoring in specialized blood clinics, unlike its older counterpart Warfarin. In a famous recent commercial, the comedian Kevin Nealon throws in his punchline by saying: “Golf clinic or blood clinic? Ooh, that’s a tough one”. However, some of these “minor” side effects may be an alarming sign that a more serious reaction is happening (literally) under a patient’s skin.
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REFERENCES

  1. “Bleeding with dabigatran, rivaroxaban, apixaban. No antidote, and little clinical experience.” Prescrire Int. 2013 Jun;22(139):155-9.
  2. Institute for Safe Medication Practices (ISMP) “QuarterWatch Monitoring FDA MedWatch Reports – Why Reports of Serious Adverse Drug Events Continue to Grow – October 3, 2012 – Data from 2012 Quarter 1” (Accessed June 2015)
  3. Institute for Safe Medication Practices (ISMP) “QuarterWatch Monitoring FDA MedWatch Reports – Anticoagulants the Leading Reported Drug Risk in 2011 – May 31, 2012 – New Data from 2011 Quarters 3 – 4” (Accessed June 2015)
  4. Chrétien B, Besnard A, Sassier M, Le Hello C, Coquerel A, Alexandre J, Fedrizzi S. Rivaroxaban-induced hair loss. Eur J Clin Pharmacol. 2015, Aug 25.
  5. Gelbricht V et al (2012) Hair loss is a potential side effect of novel oral anticoagulants—findings from the Dresden Noac Registry (NCT01588119). Blood 120:1173 (ASH Annual Meeting Abstracts)
  6. Drugs.com, “Does Xarelto cause hair loss?” http://www.drugs.com/answers/xarelto-hair-loss-736964.html