Apixaban Overdose with Massive Bleeding and Anti-Xa Levels

The authors investigate the clinical implications of a significant apixaban overdose, specifically examining the occurrence of massive bleeding and the behavior of anti-Xa levels in such cases. They present a case of a 70-year-old male who experienced severe gastrointestinal hemorrhage and subdural hematomas after ingesting a large dose of apixaban, highlighting the need for aggressive treatment and monitoring of anti-Xa levels, which showed a first-order elimination pattern despite the overdose. This case underscores the potential for life-threatening bleeding from factor Xa inhibitor overdoses, despite their rarity.