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Xarelto (rivaroxaban) Disease Interactions

There are 5 disease interactions with Xarelto (rivaroxaban):

Major

Factor Xa Inhibitors (Includes Xarelto) ↔ Bleeding

Severe Potential Hazard, Moderate plausibility

Applies to: Bleeding

The use of factor Xa inhibitors is contraindicated in patients with active pathological bleeding. Its use increases the risk of bleeding and can cause serious or fatal bleeding. Caution is recommended when prescribing these agents to patients at increased risk of bleeding. When using these agents, the risk of thrombotic events should be weighed against the risk of bleeding.

Major

Factor Xa Inhibitors (Includes Xarelto) ↔ Hepatic Impairment

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, the manufacturer recommends avoiding the use of factor Xa inhibitors in patients with moderate and severe hepatic impairment or with any hepatic disease associated with coagulopathy as drug exposure and bleeding risk may be increased.

Major

Factor Xa Inhibitors (Includes Xarelto) ↔ Renal Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Some factor Xa inhibitors such as rivaroxaban and fondaparinux should be avoided in patients with CrCl <30 mL/min. Observe closely and promptly evaluate any signs or symptoms of blood loss in patients with CrCl 30 to 50 mL/min. Treatment should be discontinued in patients who develop acute renal failure while on treatment with these drugs.

Major

Factor Xa Inhibitors (Includes Xarelto) ↔ Valvular Heart Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Prosthetic Heart Valves

The use of factor Xa inhibitors is not recommended in patients with prosthetic heart valves as no studies have been conducted for safety and efficacy.

Major

Rivaroxaban (Includes Xarelto) ↔ Unstable Blood Pressure

Severe Potential Hazard, Moderate plausibility

Applies to: Hypotension

Initiation of rivaroxaban is not recommended acutely as an alternative to unfractionated heparin in patients with pulmonary embolism who present with hemodynamic instability or who may receive thrombolysis or pulmonary embolectomy.

Xarelto (rivaroxaban) drug Interactions

There are 357 drug interactions with Xarelto (rivaroxaban)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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