How does Xarelto work?

Xarelto (rivaroxaban) works by blocking a blood protein called clotting Factor Xa (10a) that helps to stop bleeding. This action can keep blood clots from developing or getting worse.

Factor Xa activates the blood protein prothrombin to thrombin, which triggers the final actions that help to form blood clots. Xarelto belongs to an anticoagulant class of drugs known as Factor Xa inhibitors.

Also, notice that Xarelto begins with "Xa", and that's an easy way to remember how it works.

Other Factor Xa inhibitors that work like Xarelto include:

• Arixtra (fondaparinux)
• Eliquis (apixaban)
• Savaysa (edoxaban)

Pros and Cons

The newer anticoagulants are costly compared to warfarin, and may not be the right drugs for everyone. In addition, regular blood tests and food limitations are required with drugs like warfarin.

Xarelto may cause you to bleed more easily, and this is important to remember during your therapy. However, a plus with Xarelto is that it does not require regular blood tests or have food restrictions like warfarin. Studies have also shown that blood levels remain constant with Xarelto for a more predictable effect to help prevent blood clots.

Xarelto comes as a 2.5 mg, 10 mg, 15 mg or 20 mg oral tablet and is taken by mouth once or twice a day. Follow your dosing directions exactly.

Uses

• Xarelto is used to treat or prevent blood clots (venous thromboembolism, or VTE), like a deep vein thrombosis (DVT) in the leg or a lung clot (pulmonary embolism or PE)
• This medicine is also used in adults with non-valvular atrial fibrillation (a type of heart rhythm disorder that is not caused by heart valve disease) to help prevent a stroke or serious blood clot.
• It is used with aspirin to lower the risk of a heart attack, stroke or death in adults with certain types of blood vessel disease that supply blood to the heart or body.
• It’s used to prevent DVT and PE in adults who are having hip replacement or knee replacement surgery, or people in the hospital with serious illnesses at risk of a clot or who cannot move around (which may increase their risk for a clot). Xarelto might be used to lower your risk of a DVT or PE coming back after you have received treatment for blood clots for at least 6 months.
• In children, Xarelto is used to treat and prevent blood clots from happening again in those who have received at least 5 days of initial anticoagulation (blood thinner) treatment, and to prevent blood clots after heart surgery in certain children who have an abnormality in the heart that develops before birth (congenital heart disease).

This is not all the information you need to know about Xarelto for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

Related questions

• Xarelto vs Eliquis: How do they compare?
• Does Xarelto increase or decrease blood pressure?
• How long before surgery should Xarelto be stopped?

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Drug information

• Xarelto Information for Consumers
• Xarelto prescribing info & package insert (for Health Professionals)
• Side Effects of Xarelto (detailed)
• Xarelto user reviews (225)

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