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Rivaroxaban Side Effects

Medically reviewed by Last updated on May 12, 2022.

For the Consumer

Applies to rivaroxaban: oral powder for suspension, oral tablet


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.

Side effects requiring immediate medical attention

Along with its needed effects, rivaroxaban 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 while taking rivaroxaban:

More common

  • Back pain
  • bleeding gums
  • bloody stools
  • bowel or bladder dysfunction
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • coughing up blood
  • difficulty with breathing or swallowing
  • dizziness
  • headache
  • increased menstrual flow or vaginal bleeding
  • leg weakness
  • nosebleeds
  • numbness
  • paralysis
  • prolonged bleeding from cuts
  • red or black, tarry stools
  • red or dark brown urine
  • vomiting of blood or material that looks like coffee grounds

Less common

  • Fainting
  • pain in the arms or legs
  • wound secretion


  • Burning feeling while urinating
  • difficult or painful urination

Incidence not known

  • Blistering, peeling, or loosening of the skin
  • blurred vision
  • chest tightness
  • chills
  • clay-colored stools
  • cough
  • dark urine
  • diarrhea
  • fast or irregular heartbeat
  • fever with or without chills
  • general feeling of tiredness or weakness
  • hives, itching, skin rash
  • hoarseness
  • joint or muscle pain
  • loss of appetite
  • lower back or side pain
  • nausea
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • severe headache
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • stomach pain or swelling
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting
  • yellow eyes or skin

Side effects not requiring immediate medical attention

Some side effects of rivaroxaban 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

  • Blisters
  • muscle spasm

For Healthcare Professionals

Applies to rivaroxaban: oral granule for reconstitution, oral kit, oral tablet


The most common adverse reactions were bleeding complications.[Ref]

The risk of bleeding may be increased in certain patient groups, including patients with uncontrolled severe arterial hypertension and/or concomitant treatment affecting hemostasis.[Ref]


Very common (10% or more): Any bleeding

Common (1% to 10%): Anemia (including postoperative anemia)

Uncommon (0.1% to 1%): Bleeding into a critical organ, bleeding that required reoperation, decreased hemoglobin, decrease in hemoglobin by 2 g/dL (20 g/L) or more, fatal bleeding, non-fatal non-critical organ bleeding, occult blood positive, thrombocythemia, transfusion of 2 or more units of whole blood or packed red blood cells (including extra-surgical site bleeding),

Postmarketing reports: Agranulocytosis[Ref]


Common (1% to 10%): Constipation, diarrhea, dyspepsia, gastrointestinal bleeding, gastrointestinal hemorrhage (including rectal hemorrhage), gingival bleeding, nausea, toothache, upper abdominal pain, vomiting

Uncommon (0.1% to 1%): Dry mouth, gastric ulcer hemorrhage, hematochezia, hemorrhagic gastritis, hemorrhoidal hemorrhage, lip hemorrhage, lower abdominal pain, melena, mouth hemorrhage, tongue hemorrhage

Rare (less than 0.1%): Retroperitoneal bleeding[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache, syncope

Uncommon (0.1% to 1%): Cerebral and intracranial hemorrhage

Rare (0.01% to 0.1%): Cerebellar hemorrhage, fatal intracranial bleeding, hemorrhagic transformation stroke

Frequency not reported: Intraspinal bleeding, spinal/epidural hematoma

Postmarketing reports: Hemiparesis, subdural hematoma[Ref]


Following study drug discontinuation in the ROCKET AF trial, cases of stroke were reported in during the transition from rivaroxaban to warfarin in nonvalvular atrial fibrillation patients.[Ref]

Common (1% to 10%): Deep vein thrombosis, hematoma, hypertension, hypotension (include procedural hypotension), peripheral edema, tachycardia

Rare (less than 0.1%): Vascular pseudoaneurysm

Frequency not reported: Pericardial and intra-articular bleeding, symptoms of cardiac ischemia such as chest pain or angina pectoris (as a consequence of anemia)[Ref]


Common (1% to 10%): Increase in transaminases

Uncommon (0.1% to 1%): Abnormal hepatic function, increased bilirubin, increased blood alkaline phosphatase, increased gamma glutamyltransferase (GGT)

Rare (less than 0.1%): Increased conjugated bilirubin (with or without concomitant ALT increase), jaundice

Postmarketing reports: Cholestasis, cytolytic hepatitis[Ref]


Common (1% to 10%): Renal impairment (including increased blood creatinine and blood urea)

Uncommon (0.1% to 1%): Decreased creatinine renal clearance

Frequency not reported: Renal failure/acute renal failure secondary to a bleeding sufficient to cause hypoperfusion[Ref]


Postmarketing reports: Anaphylactic reaction, anaphylactic shock, hypersensitivity[Ref]


Common (1% to 10%): Blister, contusion, cutaneous and subcutaneous hemorrhage, ecchymosis, pruritus (including uncommon cases of generalized pruritus), rash, wound hemorrhage, wound secretion

Uncommon (0.1% to 1%): Allergic dermatitis, urticaria

Postmarketing reports: Angioedema, Stevens-Johnson syndrome[Ref]


Common (1% to 10%): Urinary retention, urogenital tract hemorrhage (including hematuria and menorrhagia), vaginal hemorrhage

Uncommon (0.1% to 1%): Urinary tract infection

Rare (0.01% to 0.1%): Menometrorrhagia, metrorrhagia[Ref]


Uncommon (0.1% to 1%): Hyperglycemia, increased amylase, increased LDH, increased lipase

Rare (less than 0.1%): Localized edema[Ref]


Common (1% to 10%): Arthralgia, back pain, increased muscle tone and cramping, muscle spasm, osteoarthritis, pain in extremity

Uncommon (0.1% to 1%): Hemarthrosis

Rare (less than 0.1%): Muscle hemorrhage

Frequency not reported: Intramuscular bleeding with compartment syndrome[Ref]


Common (1% to 10%): Eye hemorrhage (including conjunctival hemorrhage)

Uncommon (0.1% to 1%): Vitreous hemorrhage

Rare (less than 0.1%): Intraocular bleeding[Ref]


Common (1% to 10%): Anxiety reaction, sleep disorders[Ref]


Common (1% to 10%): Dyspnea, epistaxis, hemoptysis, oropharyngeal pain, sinusitis

Frequency not reported: Pulmonary hemorrhage and pulmonary hemorrhage with bronchiectasis[Ref]


Common (1% to 10%): Decreased general strength and energy (including fatigue and asthenia), fever

Uncommon (0.1% to 1%): Feeling unwell (including malaise)[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Xarelto (rivaroxaban)." Bayer Inc (2008):

Further information

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

Some side effects may not be reported. You may report them to the FDA.