What is Xarelto (Rivaroxaban)?
Xarelto (rivaroxaban) is a medication prescribed to:
- Prevent blood clots
- Treat or prevent deep vein thrombosis (DVT), especially after hip or knee replacement surgery
- Treat pulmonary embolism (PE)
- Prevent getting DVT or PE again
- Help prevent strokes or blood clots due to a certain irregular heartbeat (atrial fibrillation)
- Lower the risk of stroke, heart attack, or death in people with coronary artery disease (CAD)
- Prevent blood clots in children in children 2 years and older after heart surgery
- Treat blood clots in children from birth to 18 years after they receive at least 5 days of blood thinner (anticoagulation) treatment
- Reduce the risk of complications from poor circulation in the blood vessels (peripheral arterial disease)
Xarelto belongs to the drug class factor Xa inhibitors. These medications work by blocking certain clotting proteins in your blood.
Xarelto is not recommended:
- If you are allergic or have had an allergic reaction to Xarelto or ingredients in Xarelto
- If you are pregnant or planning to become pregnant
- If you suffer from abnormal bleeding
- If you suffer from liver disease
What are the Indications for Xarelto?
Xarelto is approved to prevent and treat blood clots, DVT, and PE, prevent stroke, and lower the risk of a heart attack in adults. It is also approved to prevent blood clots in children in children 2 years and older after heart surgery and treat blood clots in children from birth to 18 years after they receive at least 5 days of blood thinner treatment.
How is Xarelto used?
Xarelto should be stored in its original packaging at between 68-77°F (20-25°C) with excursions permitted between 59-86°F (15-30°C).
Store medication in a dry place away from light and moisture.
Keep out of reach of children.
Take Xarelto orally and exactly as directed by your doctor. Depending on your condition or the strength of your medication your doctor will tell you if you should take it with or without food. Swallow the tablet whole. Do not split, chew, or crush the tablet. Do not freeze the oral suspension.
Do not change your dosage and take more than what is prescribed or stop using Xarelto without consulting with your doctor. If you suddenly stop taking Xarelto, it can increase your risk of blood clots or stroke. If you took more than prescribed, contact your doctor immediately or seek emergency medical care. An overdose may cause excessive bleeding.
If you miss a dose, skip the dose, and take your next dose at the regular time. Do not catch up by taking two doses at once. If you took more than prescribed, contact your doctor immediately or seek emergency medical care.
Xarelto is available in tablet form in these strengths: 2.5 mg, 10 mg, 15 mg, and 20 mg.
It is also available as an oral suspension liquid with a strength of 1 mg/mL.
Your doctor will determine your dosage depending on the condition being treated. The typical starting dose of Xarelto is 10 mg once a day.
The dosage in children and teenagers is based on their weight and may change as they grow or if they lose weight.
It’s important to understand that although Xarelto is FDA-approved, it comes with side effects that may or may not affect you.
Before using Xarelto, you should discuss possible side effects with your doctor or pharmacist.
Common Side Effects
Not all side effects require medical attention. As your body adjusts to Xarelto, side effects may go away. Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own:
- Minor bleeding
- Stomach issues: pain or inflammation
- Back pain
- Trouble sleeping
- Muscle pain/spasm
Serious Side Effects
Severe adverse reactions while using Xarelto may occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:
- Signs of serious bleeding:
- nosebleeds, bleeding from cuts or gums, heavy or long menstrual flow
- pain or swelling, bruising
- headache, dizziness, tiredness, fainting
- pink/dark urine
- coughing up blood, vomit that is bloody or looks like coffee granules
- black tarry stools
- Severe allergic reaction: a rash over your whole body, sweating, extreme drowsiness, swelling of your face, tongue, or throat, difficulty breathing or swallowing, feeling faint, dizziness, rapid heartbeat, shortness of breath, or becoming confused.
- Spinal blood clot: back pain, numbness/tingling, muscle weakness, loss of bladder/bowel control.
- Other:vision changes, confusion, trouble speaking, weakness on one side of the body.
The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.
Warnings & Precautions
Before taking Xarelto, tell your doctor or pharmacist if you:
- Have any kidney disease or undergoing dialysis
- Had major surgery or trauma recently
- Are having any surgery or dental work
- Have a history of stroke
- Suffer from any bleeding disorders or have a family history of bleeding disorders
- Have ulcerative gastrointestinal disease
Surgery or dental work
If you need surgery or dental work, you may need to stop this medicine for a short time. Let your doctor know that you are using Xarelto before the time.
Xarelto may cause serious bleeding so use sharp objects with caution and avoid activities where you can get injured, like contact sports. Use a soft toothbrush and an electric shaver. Contact your doctor immediately if you injure yourself.
Xarelto can cause stomach bleeding and drinking alcohol can increase this risk. Avoid using alcohol while taking Xarelto or speak to your doctor about a safe amount to consume.
Pregnant or planning to become pregnant
Let your doctor know if you are pregnant or planning to become pregnant. Your doctor will determine if the benefit of taking Xarelto outweighs the risk. It can cause bleeding in the mother and unborn baby.
Breastfeeding or planning to breastfeed
Speak to your doctor if you are breastfeeding or planning to breastfeed. Do not use Xarelto while you are breastfeeding as it may pass into your breastmilk and harm your baby. Speak to your doctor before you start breastfeeding.
Interactions & Contraindications
Before you use Xarelto, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins. Xarelto may affect how some medicines work, and other medicines may affect how Xarelto works.
Xarelto can interact with certain nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, aspirin, SSRIs, and SNRIs to treat depression or anxiety, antifungal medications, HIV/Aids medications, or other medication to treat blood clots.