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:
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
References
- FDA Approves Two New Indications for Xarelto (rivaroxaban) to Help Prevent and Treat Blood Clots in Pediatric Patients. Drugs.com. Dec. 20, 2021. Accessed May 31, 2023 at https://www.drugs.com/history/xarelto.html
- Vinogradova Y, Coupland C, Hill T, et al. Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. BMJ 2018;362:k2505. Accessed May 31, 2023.
- Xarelto [package insert]. Titusville, NJ. Janssen Pharmaceuticals. Revised Feb. 2022. Accessed May 31, 2023 at https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/XARELTO-pi.pdf
- Newer Blood Thinners May Not Bring Higher Bleeding Risk. Drugs.com. Oct. 18, 2017. Accessed May 13, 2020.
Read next
How long before surgery should Xarelto be stopped?
Ideally, Xarelto (rivaroxaban) should be stopped at least 24 hours before surgery in a person with normal renal function who is undergoing a low bleeding risk procedure or 48 to 72 hours before if the procedure is high-risk. For somebody with impaired renal function (CLCR of 30-50 ml/min) undergoing a low bleeding risk procedure, Xarelto should be stopped 48 hours before, or 48 to 72 hours before if the procedure is high risk. Continue reading
How do you reverse bleeding with Xarelto?
Andexxa injection is an antidote that can be used for patients being treated with rivaroxaban (Xarelto) or apixaban (Eliquis) when reversal of anticoagulation (blood thinning) is needed due to life-threatening or uncontrolled bleeding. Continue reading
Does Feverfew interact with any drugs?
Feverfew, an herbal supplement that is a member of the daisy family, may interact with over 40 medicines. This includes drugs used to help prevent blood clots like the anticoagulant warfarin. Continue reading
Related medical questions
- What are biologic drugs and how do they work?
- What do you need to know about Blood Thinners?
- 6 Wegovy side effects you need to be aware of
- How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?
- How long does it take for Ozempic to work?
- Ozempic vs Wegovy: What's the difference between them?
- How many doses are in an Ozempic pen?
- How long until I lose weight on Wegovy?
- Tirzepatide vs semaglutide: How do they compare?
- What happens when you stop taking Ozempic?
- Do Ozempic, Wegovy, Mounjaro & Zepbound cause hair loss?
- What are the long-term side effects of Ozempic?
- Does Ozempic need to be refrigerated?
- Will my insurance cover the cost of Ozempic?
- Can you get tirzepatide from a compounding pharmacy?
- Saxenda vs Ozempic: For Weight Loss?
- Why am I not losing weight on Ozempic?
- Where and how should Ozempic be injected?
- How much does semaglutide cost?
- How do you get Wegovy covered by insurance?
- How does Ozempic affect blood pressure?
- How to avoid yeast infections on Jardiance?
- Is psyllium husk an affordable weight loss option to Ozempic?
- Does Jardiance cause weight loss?
- How long can you stay on Ozempic?
- How long does Ozempic last in your system?
- How does taking Ozempic affect your face?
- Rybelsus vs Ozempic for weight loss: Which to choose?
- Trulicity vs Ozempic: Which is right for you?
- Why does Ozempic cause a dry mouth or taste changes?
Drug information
- Xarelto Information for Consumers
- Xarelto prescribing info & package insert (for Health Professionals)
- Side Effects of Xarelto (detailed)
- Xarelto user reviews (223)
Related support groups
- Xarelto (111 questions, 419 members)
- Cardiovascular Risk Reduction (88 questions, 27 members)
- Deep Vein Thrombosis (DVT) (55 questions, 187 members)
- Atrial Fibrillation (108 questions, 356 members)
- Deep Vein Thrombosis (21 questions, 48 members)
- Pulmonary Embolism (28 questions, 106 members)
- Prevention of Thromboembolism in Atrial Fibrillation (26 questions, 40 members)
- Coronary Artery Disease (CAD) (25 questions, 29 members)
- Pulmonary Embolism - Recurrent Event (14 questions, 35 members)
- Deep Vein Thrombosis Prophylaxis after Knee Replacement Surgery (13 questions, 6 members)
- Deep Vein Thrombosis - Recurrent Event (13 questions, 40 members)