Xarelto

rivaroxaban

Brand(s):

• Xarelto

Manufacturer:

• Bayer Pharma AG

Disease(s):

• Deep Vein Thrombosis / DVT / Pulmonary Embolism / Formation Of Blood Clots / Atrial Fibrillation / Heart Rhythm Disorder

Rivaroxaban Tablets

What is Rivaroxaban?

Rivaroxaban is an anticoagulant, more commonly known as a blood thinner. Its primary function is to prevent the formation of blood clots.

The brand name for rivaroxaban is Xarelto. It's prescribed to prevent or treat deep vein thrombosis (DVT), a type of blood clot that can travel to the lungs and cause a pulmonary embolism. DVT often occurs after certain surgeries.

Xarelto is also used in individuals with atrial fibrillation (an irregular heartbeat) to reduce the risk of stroke caused by blood clots. It may also have other off-label uses.

Important Safety Information

Rivaroxaban is not suitable for everyone. You should avoid using Xarelto if you have an artificial heart valve or if you're experiencing active or uncontrolled bleeding.

A serious risk associated with rivaroxaban is the potential for a spinal cord blood clot (spinal hematoma). This is especially true if you're undergoing a spinal tap or epidural anesthesia. This complication is more likely if you have:

• A genetic spinal defect
• A spinal catheter in place
• A history of spinal surgery or repeated spinal taps
• Recently had a spinal tap or epidural
• Are currently taking NSAIDs (like Advil, Aleve, or Motrin)
• Are using other blood-thinning medications

Seek immediate medical attention if you experience symptoms of a spinal cord blood clot, such as back pain, numbness or weakness in your lower body, or loss of bladder or bowel control. This can lead to long-term or permanent paralysis.

Never stop taking rivaroxaban suddenly without consulting your doctor. Abrupt cessation can significantly increase your risk of blood clots or stroke.

Before Starting Rivaroxaban

Rivaroxaban is contraindicated (should not be used) if you are allergic to rivaroxaban or have:

• An artificial heart valve
• Active or uncontrolled bleeding

Increased bleeding risk: Rivaroxaban can make you bleed more easily, particularly if you have:

• An inherited or acquired bleeding disorder
• Hemorrhagic stroke
• Uncontrolled high blood pressure
• Stomach or intestinal bleeding or ulcers
• Are taking medications such as aspirin, heparin, warfarin, or clopidogrel.

Inform your doctor about any kidney or liver disease before starting rivaroxaban.

Pregnancy and breastfeeding: Rivaroxaban falls under FDA pregnancy category C. Its effects on unborn babies are unknown, but it could cause bleeding complications during childbirth. Breastfeeding is not recommended while using Xarelto.

Pregnancy and Breastfeeding Warnings

The safety of rivaroxaban during pregnancy and breastfeeding is not fully established. Discuss the risks and benefits with your doctor. Breastfeeding is generally not recommended while taking this medication.

How to Take Rivaroxaban

Always follow your doctor's instructions precisely. The dosage and frequency (once or twice daily) depend on the specific condition being treated. Never adjust your dose without consulting your doctor.

Dosage examples (this is not exhaustive, always refer to your prescription):

• Atrial fibrillation: Often 20 mg once daily with the evening meal.
• Hip or knee replacement surgery: Typically 10 mg once daily, starting 6-10 hours post-surgery.
• DVT and PE treatment: Usually starts with 15 mg twice daily for the first 21 days, then 20 mg once daily.

Inform all healthcare providers that you're taking rivaroxaban, especially before any surgery or dental procedures. You might need to temporarily stop taking the medication before certain medical procedures.

Store rivaroxaban at room temperature, away from moisture and heat.

Missed Dose

For once-daily dosing: Take the missed dose as soon as you remember, then resume your usual schedule. Do not double up on doses.

For twice-daily dosing: Take the missed dose as soon as you remember. You may take two doses at the same time to catch up.

Overdose

Seek immediate medical attention or contact a poison control center if you suspect an overdose. Excessive bleeding is a primary symptom of rivaroxaban overdose.

Things to Avoid

Minimize activities that could increase your risk of bleeding or injury. Take extra precautions during activities like shaving or brushing your teeth.

Rivaroxaban Side Effects

Seek immediate medical help if you experience any signs of an allergic reaction (hives, difficulty breathing, facial swelling) or symptoms of a spinal blood clot (back pain, lower body weakness, loss of bladder/bowel control).

Contact your doctor immediately if you notice:

• Easy bruising or bleeding
• Pain, swelling, or drainage from a wound
• Uncontrollable bleeding
• Headache, dizziness, weakness, fainting
• Red, pink, or brown urine
• Bloody or tarry stools

Common side effects can include muscle pain, itching, and pain in the arms or legs. This isn't an exhaustive list, and other side effects may occur.

Rivaroxaban Dosing Information (Detailed)

Note: This information is for general knowledge and should not replace your doctor's specific instructions.

Deep Vein Thrombosis (DVT) Prophylaxis after Hip Replacement: 10 mg orally once daily, starting 6-10 hours post-surgery. Treatment duration is typically 35 days.

DVT Prophylaxis after Knee Replacement: 10 mg orally once daily, starting 6-10 hours post-surgery. Treatment duration is typically 12 days.

Atrial Fibrillation: 20 mg orally once daily with the evening meal.

DVT and Pulmonary Embolism (PE) Treatment: Initial dose: 15 mg orally twice daily with food for 21 days. Maintenance dose: 20 mg orally once daily with food.

DVT and PE Recurrence Prevention: 20 mg orally once daily with food.

Drug Interactions

Inform your doctor about all medications you are taking, including over-the-counter drugs, supplements, and herbal remedies. Certain medications can interact with rivaroxaban, potentially affecting its efficacy or increasing the risk of side effects. Some examples include:

• Rifampin
• St. John's wort
• Antifungal medications (itraconazole, ketoconazole)
• HIV medications (indinavir, lopinavir, ritonavir)
• Seizure medications (carbamazepine, phenobarbital, phenytoin)

This is not a complete list. Always consult your doctor or pharmacist about potential drug interactions.