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Rivaroxaban (Oral)

Generic name: rivaroxaban [ riv-a-ROX-a-ban ]
Brand name: Xarelto
Drug class: Factor Xa inhibitors

Medically reviewed by Drugs.com. Last updated on Jul 29, 2023.

Oral route(Tablet)

Premature discontinuation of any oral anticoagulant, including rivaroxaban, increases the risk of thrombotic events. To reduce this risk, consider coverage with another anticoagulant if rivaroxaban is discontinued for a reason other than pathological bleeding or completion of a course of therapy. Epidural or spinal hematomas, which may result in long-term or permanent paralysis, have occurred in patients treated with rivaroxaban who are receiving neuraxial anesthesia or undergoing spinal puncture. Optimal timing between the administration of rivaroxaban and neuraxial procedures is not known. Factors that can increase the risk of developing hematomas include: use of indwelling epidural catheters; concomitant use of drugs affecting hemostasis, such as NSAIDs, platelet inhibitors, or other anticoagulants; or a history of traumatic or repeated epidural or spinal punctures, spinal deformity, or spinal surgery. Monitor patients frequently for neurological impairment. If neurological compromise is noted, urgent treatment is necessary. Consider risks/benefits before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis .

Uses for rivaroxaban

Rivaroxaban is used to treat and prevent deep venous thrombosis (DVT), a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism (PE). This medicine is used for several days after hip or knee replacement surgery while you are unable to walk. It is during this time that blood clots are most likely to form. It also reduces the risk of blood clots occurring again in patients who are still at risk for DVT or PE after receiving treatment for at least 6 months.

Rivaroxaban is also used to prevent stroke and blood clots in patients with certain heart rhythm problems (eg, nonvalvular atrial fibrillation). It is also used together with aspirin to decrease the risk of serious heart problems, heart attack, and stroke in patients with coronary artery disease (a condition where the blood supply to the heart is reduced or blocked). This medicine is also used together with aspirin to lower the risk of sudden decrease in blood flow to the legs, major amputation, heart attack, or stroke in patients with peripheral artery disease (a condition where the blood flow to the legs is reduced), including patients who have had a recent surgery to improve blood flow to the legs. This medicine is also used to prevent venous thromboembolism (VTE) in certain patients that are hospitalized for an acute illness and after discharge who are at risk of getting blood clots because of decreased ability to move around (mobility) and who do not have a high risk of bleeding. It is also used to treat or reduce the risk of venous thromboembolism (VTE) after receiving at least 5 days of medicine to treat blood clots and helps prevent blood clots in patients with congenital heart disease after undergoing the Fontan procedure.

Rivaroxaban is a factor Xa inhibitor, an anticoagulant. It works by decreasing the clotting ability of the blood and helps prevent harmful clots from forming in the blood vessels.

This medicine is available only with your doctor's prescription.

Before using rivaroxaban

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of rivaroxaban to treat and prevent venous thromboembolism in children and to prevent blood clots in children 2 years of age with congenital heart disease. Safety and efficacy have been established. Use is not recommended in children younger than 6 months of age who were less than 37 weeks of growth at birth, had less than 10 days of oral feeding, or weighing less than 2.6 kilograms (kg).

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of rivaroxaban in the elderly. However, elderly patients are more likely to have bleeding and blood clotting problems, which may require caution and an adjustment in the dose for patients receiving rivaroxaban.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Proper use of rivaroxaban

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine should come with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

The 2.5 and 10 mg tablets can be taken with or without food. The 15 and 20 mg tablets should be taken with food. Also, take this medicine at the same time each day.

If you are unable to swallow the tablets whole:

If your child is unable to swallow the tablets whole, you may use the oral liquid.

To use the oral liquid:

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed Dose

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Once-daily dosing: If you miss a dose, take it as soon as you can on the same day. Then take your regularly scheduled dose the next day.

Twice-daily dosing to prevent serious heart or blood vessel problems (2.5 mg tablet): If you miss a dose, skip the missed dose and take your next dose at your usual time.

Twice-daily dosing to treat a blood clot (oral liquid or 15 mg tablet): If you miss a dose, take it as soon as you can on the same day. You may take 2 doses at the same time to make up for the missed dose. Then take your regularly scheduled doses the next day.

Thrice-daily dosing: If you miss a dose, skip the missed dose, then take your regularly scheduled doses the next day.

Oral liquid: If your child vomits or spits up right after or within 30 minutes after taking the medicine, give another dose. If it is more than 30 minutes, give the next dose at the regular time. Call your doctor right away if your child vomits or spits out the medicine repeatedly.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

You may store the crushed tablet with applesauce or water mixture for up to 4 hours.

Throw away the oral liquid 60 days after opening.

Precautions while using rivaroxaban

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests will be needed to check for unwanted effects. Be sure to keep all appointments.

You may bleed or bruise more easily while you are using this medicine. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Be careful when using sharp objects, including razors and fingernail clippers. Avoid nose picking and forceful nose blowing.

Make sure any doctor or dentist who treats you knows that you are using this medicine.

This medicine may cause bleeding problems. This risk is higher if you have a catheter in your back for pain medicine or anesthesia (sometimes called an "epidural"), or if you have kidney problems. The risk of bleeding increases if your kidney problems get worse. Check with your doctor right away if you have any unusual bleeding or bruising, black, tarry stools, bleeding gums, blood in the urine or stools, tingling, numbness, or weakness of the lower legs, or pinpoint red spots on your skin.

Check with your doctor right away if you have a decreased urine output, confusion, dizziness, nausea, rapid weight gain, swelling of the face, ankles, or hands, or unusual tiredness or weakness after receiving the medicine. These may be symptoms of a serious kidney problem.

Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.

Do not suddenly stop taking this medicine without first checking with your doctor. Doing so, may increase your risk of having a stroke.

Make sure your doctor knows if you are pregnant or planning to become pregnant during treatment with this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Side Effects of rivaroxaban

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Less common

Rare

Incidence not known

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Commonly used brand name(s)

In the U.S.

Available Dosage Forms:

Therapeutic Class: Anticoagulant

Pharmacologic Class: Factor Xa Inhibitor

Frequently asked questions

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.