Questions about Atrial Fibrillation? Get answers from our expert.

Generic Name: rivaroxaban (RIV a ROX a ban)
Brand Name: Xarelto

What is rivaroxaban?

Rivaroxaban is an anticoagulant (blood thinner) that prevents the formation of blood clots.

Rivaroxaban is used to prevent or treat a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery.

Rivaroxaban is also used in people with atrial fibrillation (a heart rhythm disorder) to lower the risk of stroke caused by a blood clot.

Rivaroxaban may also be used for purposes not listed in this medication guide.

What is the most important information I should know about rivaroxaban?

You should not use this medication if you have an artificial heart valve, or if you have active or uncontrolled bleeding.

Rivaroxaban can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot can lead to long-term or permanent paralysis.

Call your doctor at once if you have any numbness, tingling, or muscle weakness (especially in your legs and feet), or loss of movement in any part of your body.

Do not stop taking rivaroxaban without first talking to your doctor. Stopping suddenly can increase your risk of blood clot or stroke.

What should I discuss with my healthcare provider before taking rivaroxaban?

You should not use this medication if you are allergic to rivaroxaban, or if you have:

  • an artificial heart valve; or

  • active or uncontrolled bleeding.

Rivaroxaban can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if you have:

  • a genetic spinal defect;

  • a history of spinal surgery or repeated spinal taps;

  • if you take an NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or

  • if you are using other medications to treat or prevent blood clots.

Rivaroxaban may cause you to bleed more easily, especially if you have:

  • a bleeding disorder that is inherited or caused by disease;

  • hemorrhagic stroke;

  • uncontrolled high blood pressure;

  • stomach or intestinal bleeding or ulcer; or

  • if you take certain medicines such as aspirin, heparin, warfarin (Coumadin, Jantoven), or clopidogrel (Plavix).

To make sure you can safely take rivaroxaban, tell your doctor if you have kidney or liver disease.

FDA pregnancy category C. It is not known whether rivaroxaban will harm an unborn baby. However, this medicine could cause bleeding complications during childbirth. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether rivaroxaban passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using rivaroxaban.

How should I take rivaroxaban?

Rivaroxaban is taken either once per day or two times per day, depending on the reason you are using this medication. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

For atrial fibrillation: Take the rivaroxaban 15-milligram or 20-milligram tablet with your evening meal.

For hip or knee replacement surgery: You may take the rivaroxaban 10-milligram tablet with or without food.

Tell your doctor if you have trouble swallowing a rivaroxaban tablet.

Tell any doctor who treats you that you are using rivaroxaban. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication. If you need anesthesia for a medical procedure or surgery, you may need to stop using rivaroxaban for a short time.

Use rivaroxaban regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not change your dose or stop taking this medication without first talking to your doctor. Stopping suddenly can increase your risk of blood clot or stroke.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

If you take rivaroxaban 1 time each day: Take the missed dose as soon as you remember. Take your next dose the following day and stay on your once-daily schedule. Do not take extra medicine to make up the missed dose.

If you take rivaroxaban 2 times each day: Take the missed dose as soon as you remember. You may take 2 doses at the same time to make up a missed dose. Skip the missed dose if it is almost time for your next scheduled dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause excessive bleeding.

What should I avoid while taking rivaroxaban?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Rivaroxaban side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • easy bruising or bleeding (nosebleeds, bleeding gums, heavy menstrual bleeding);

  • pain, swelling, or drainage from a wound or where a needle was injected in your skin;

  • bleeding from wounds or needle injections, any bleeding that will not stop;

  • headache, dizziness, weakness, feeling like you might pass out;

  • urine that looks red, pink, or brown; or

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Less serious side effects may include:

  • muscle pain;

  • itching; or

  • pain in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect rivaroxaban?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with rivaroxaban, especially:

  • St. John's wort;

  • antifungal medication--itraconazole or ketoconazole;

  • HIV medication--indinavir, lopinavir, ritonavir; or

  • seizure medication--carbamazepine, phenobarbital, phenytoin.

This list is not complete. Other drugs may interact with rivaroxaban, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about rivaroxaban.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.03. Revision Date: 2014-04-13, 8:24:57 PM.

Hide
(web4)