Bleeding Complication in a Patient with Concomitant Use of Rivaroxaban and Saffron Supplement: A Case Report

Background: Direct oral anticoagulants (DOACs) carry a lower potential risk of food/herb and drug interactions compared to oral vitamin K antagonists. However, as a new class of medications, drug interactions of DOACs have not been fully known. Case Presentation: We herein present the case of a 64-year old male with the complaint of acute onset epistaxis and bleeding gums following the concomitant use of rivaroxaban and saffron supplement. It seems that coadministration of DOACs and saffron supplements should be avoided due to the potential drug-herbal interactions and possible risk of subsequent bleeding complications. Conclusion: However, further larger-scale surveillance studies are needed to confirm the findings and assess the clinical significance.