{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:18:36Z","timestamp":1788337116177,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hosp Pharm"],"abstract":"\n Background:<\/jats:title>\n \n Nigella sativa<\/jats:italic>\n (black seed) oil is a commonly used herbal supplement. Here, we report the case of a patient enrolled in a clinical trial of\n N. sativa<\/jats:italic>\n oil for chemotherapy-induced peripheral neuropathy (CIPN), who developed a large subcutaneous hematoma while receiving oxaliplatin-based chemotherapy in combination with dual antiplatelet therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Case Presentation:<\/jats:title>\n \n A 51-year-old man with colon cancer receiving FOLFOX plus cetuximab and dual antiplatelet therapy developed a large subcutaneous hematoma while participating in a clinical trial evaluating\n N. sativa<\/jats:italic>\n oil for CIPN. After dose escalation to 2000\u2009mg\/day, progressive swelling and marked ecchymosis developed. Laboratory testing revealed clinically significant thrombocytopenia (platelet count: 52\u2009\u00d7\u200910\n 3<\/jats:sup>\n \/\u00b5L). All suspected hemostasis-modifying agents were interrupted, and supportive management was initiated, resulting in complete resolution of the hematoma within 10\u2009days. The patient was later re-exposed to a reduced dose (1000\u2009mg\/day) without recurrence of bleeding. The Naranjo Adverse Drug Reaction Probability Scale yielded a score of 4, indicating a possible adverse drug reaction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n This case suggests a possible hemorrhagic complication in a patient with multiple concurrent bleeding risk factors, including dual antiplatelet therapy and chemotherapy-associated thrombocytopenia, in the setting of\n N. sativa<\/jats:italic>\n oil exposure. It highlights the importance of systematically documenting herbal supplement use and proactively counseling patients about potential herb-drug interactions during cytotoxic chemotherapy.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration:<\/jats:title>\n \n Iranian Registry of Clinical Trials (IRCT),\n https:\/\/www.irct.ir<\/jats:ext-link>\n , IRCT20090613002027N24.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00185787261482136","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:53:00Z","timestamp":1788169980000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extensive Subcutaneous Hematoma in a Patient Receiving\n Nigella sativa<\/i>\n Oil, Dual Antiplatelet Therapy, and Oxaliplatin-Based Chemotherapy: A Case Report"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5895-4454","authenticated-orcid":false,"given":"Amirhosein","family":"Arab","sequence":"first","affiliation":[{"name":"Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-4732","authenticated-orcid":false,"given":"Sima","family":"Ramezaninejad","sequence":"additional","affiliation":[{"name":"Babol University of Medical Sciences, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebrahim","family":"Salehifar","sequence":"additional","affiliation":[{"name":"Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.0716"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000000047"},{"key":"e_1_3_2_4_2","first-page":"390","article-title":"Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials","volume":"37","author":"Udell JA","year":"2016","unstructured":"Udell JA, Bonaca MP, Collet J-P, et al. Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. Eur Heart J. 2016;37:390-399.","journal-title":"Eur Heart J"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2174\/138920008786927785"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2017.1315101"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcb.23237"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2024.1791"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.3831\/KPI.2017.20.021"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17040474"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.8390"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0731-7085(98)00300-8"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/cells14221827"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-871288"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-957994"},{"key":"e_1_3_2_16_2","volume-title":"Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0","author":"National Institutes of Health, National Cancer Institute","year":"2017","unstructured":"National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. U.S. Department of Health and Human Sciences, National Institutes of Health and National Cancer Institute; 2017."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032709"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279512"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.08.037"},{"key":"e_1_3_2_20_2","article-title":"Clinical characteristics, treatment, and outcomes of oxaliplatin-induced immune thrombocytopenia","volume":"17","author":"Huang N","year":"2026","unstructured":"Huang N, Liu Z, Li R, et al. Clinical characteristics, treatment, and outcomes of oxaliplatin-induced immune thrombocytopenia. Front Immunol. 2026;17:1809508.","journal-title":"Front Immunol"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"}],"container-title":["Hospital Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00185787261482136","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00185787261482136","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00185787261482136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:48:23Z","timestamp":1788335303000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00185787261482136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":20,"alternative-id":["10.1177\/00185787261482136"],"URL":"https:\/\/doi.org\/10.1177\/00185787261482136","relation":{},"ISSN":["0018-5787","1945-1253"],"issn-type":[{"value":"0018-5787","type":"print"},{"value":"1945-1253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"article-number":"00185787261482136"}}