Indications
Xarelto (active ingredient: rivaroxaban) is a prescription medication indicated for the following uses:
- Prevention of Stroke and Systemic Embolism in Nonvalvular Atrial Fibrillation (NVAF): Xarelto is used to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
- Treatment of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): It is indicated for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and to reduce the risk of recurrence of these conditions.
- Prophylaxis of Deep Vein Thrombosis (DVT): Xarelto is used to prevent DVT, which may lead to pulmonary embolism in patients undergoing knee or hip replacement surgery.
- Reduction of Risk of Major Cardiovascular Events: Xarelto is indicated to reduce the risk of major cardiovascular events (cardiovascular death, myocardial infarction, and stroke) in patients with chronic coronary artery disease (CAD) or peripheral artery disease (PAD).
- It is used to reduce the risk of venous thromboembolism (VTE) in acutely ill medical patients at risk for thromboembolic complications not at high risk of bleeding.
- Prophylaxis of Venous Thromboembolism (VTE) in Pediatric Patients: Xarelto is indicated for the prophylaxis of VTE and the treatment of DVT and PE in pediatric patients from birth to less than 18 years old after at least 5 days of initial parenteral anticoagulant treatment.
Xarelto belongs to the drug class known as factor Xa inhibitors (anticoagulants), which work by inhibiting the activity of factor Xa, an important component of the blood coagulation cascade, thus preventing the formation of clots.
Uses and Dosage
Xarelto is available in tablet form and is typically taken orally as directed by your doctor, usually once a day with the evening meal. It is important to take Xarelto exactly as prescribed by your doctor, and not to exceed the recommended dosage. Take Xarelto at the same time each day; missing doses may increase the risk of a blood clot forming. If you forget to take Xarelto, take it as soon as you remember, unless it is almost time for your next dose. Do not take two doses at once.
For Deep Vein Thrombosis (DVT) Treatment
- For the first 21 days, 15 mg twice daily with food, at the same time each day in patients with a Creatinine clearance (CrCl ≥15 mL/min). Starting at day 22, change to 20 mg once daily with food, at the same time each day, for remaining treatment in patients with a CrCl ≥15 mL/min. Avoid use in patients with Creatinine clearance CrCl <15 mL/min.
For Reduction in the Risk of Recurrence
- 10 mg once daily with or without food after ≥6 months of standard anticoagulant treatment in patients with a CrCl ≥15 mL/min
For After Hip Replacement Surgery
- 10 mg once daily for 35 days, 6 to 10 hours after surgery once hemostasis has been established, with or without food, in patients with a CrCl ≥15 mL/min. Avoid use in patients with CrCl <15 mL/min.
For Acutely Ill Medical Patients
- 10 mg once daily, in hospital and after hospital discharge, for a total recommended duration of 31 to 39 days, with or without food, in patients with a CrCl ≥15 mL/min. Avoid use in patients with CrCl <15 mL/min.
Side Effects
Common side effects of rivaroxaban include:
- Bruising
- Constipation
- Diarrhea
- Dizziness
- Easy bruising
- Fainting
- Fatigue
- Fever
- Itching
- Minor bleeding
- Nausea
- Vomiting
- Wound secretion
Serious Side Effects of Serious Side Effects include:
- Blood in the stool
- Bowel or bladder problems
- Confusion
- Difficulty swallowing
- Fainting
- Persistent dizziness
- Persistent or frequent nosebleeds
- Prolonged bleeding from cuts
- Trouble speaking
- Unusual pain, swelling, or discomfort
- Unusual weakness, numbness, or paralysis
- Vision changes
- Vomiting with blood
- Weakness on one side of the body
Form and Strength
Xarelto and its generic alternative form Rivaroxaban are available in the following forms and strengths:
Xarelto: Film Coated Tablet
- 2.5 mg
- 10 mg
- 15 mg
- 20 mg
Rivaroxaban: Tablet
- 2.5 mg
- 10 mg
- 15 mg
- 20 mg
Caution
- Before taking rivaroxaban, it is important to inform your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients which may cause allergic reactions or other problems. For more information, it is advisable to consult your pharmacist.
- Regular consumption of alcoholic beverages while on this medication may increase the risk of stomach bleeding. Therefore, it is advisable to limit alcoholic beverages. Your doctor or pharmacist can provide more information on how much alcohol can be safely consumed.
- Patients with triple positive antiphospholipid syndrome (APS) are at an increased risk of thrombosis when using prosthetic heart valves, and as such, the use of Xarelto is not recommended for such patients.
- You should inform your doctor if you are pregnant or plan to become pregnant. This medication should only be used during pregnancy when clearly necessary, and the potential risks and benefits should be discussed with your doctor before using it.
- If you are taking Xarelto daily and miss a dose, you should take it as soon as you remember. If it is close to the time of your next scheduled dose, it is best to skip the missed dose and take your next dose at the regular time. Doubling the dose to make up for a missed dose is not recommended.
Frequently Asked Questions (FAQ)
What is Xarelto (Rivaroxaban)?
Xarelto (Rivaroxaban) is a blood thinner that is used to reduce the risk of stroke, blood clots, and other serious medical conditions. It is also known as a direct factor Xa inhibitor.
How does Xarelto (Rivaroxaban) work?
Xarelto (Rivaroxaban) works by inhibiting an enzyme in the blood called Factor Xa, which is responsible for clot formation. By inhibiting this enzyme, it helps to reduce the risk of blood clots and stroke.
What are the side effects of Xarelto (Rivaroxaban)?
The most common side effects of Xarelto (Rivaroxaban) include bleeding, dizziness, nausea, headaches, and skin rash. Other side effects may include bleeding in the brain, increased risk of infection, and increased risk of blood clots.
Who should not take Xarelto (Rivaroxaban)?
Xarelto (Rivaroxaban) should not be taken by people who are pregnant, breastfeeding, or have an active bleeding disorder. People with liver or kidney problems should also not take Xarelto (Rivaroxaban).
Resources
- https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/XARELTO-pi.pdf
- https://www.xarelto-us.com/
- https://www.rxlist.com/consumer_rivaroxaban_xarelto/drugs-condition.htm
- https://www.webmd.com/drugs/2/drug-156265-1153/xarelto-oral/rivaroxaban-oral/details
- https://www.nhs.uk/medicines/rivaroxaban/common-questions-about-rivaroxaban/
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