Xarelto (rivaroxaban) Indications
Xarelto is a prescription medication used in adults to:
- Reduce the risk of stroke and blood clots in those with atrial fibrillation, an irregular and often rapid heart rhythm that can lead to the formation of blood clots. Atrial fibrillation is not caused by a heart valve problem.
- Treat blood clots in the veins of your legs (deep vein thrombosis, or DVT) or lungs (pulmonary embolism, or PE)
- Reduce the risk of blood clots from recurring in adults who continue to be at risk for DVT or PE after being treated for blood clots for at least 6 months
- Help prevent DVT or PE in adults who have just had hip or knee replacement surgery
- Help prevent blood clots in certain adults hospitalized for an acute illness and following hospital discharge because of the loss of or decreased ability to move around
Xarelto is used in children to:
- Treat blood clots or reduce the risk of blood clots from recurring in children from birth to less than 18 years, after receiving at least 5 days of treatment with injectable or intravenous medicines used to treat blood clots
- Help prevent blood clots in those 2 years and older with congenital heart disease after the Fortan procedure
Xarelto Uses and Dosage
Regardless of which condition you are taking Xarelto for, it is important to take it exactly as prescribed by your doctor. The recommended Xarelto dosages are as follows:
|Atrial fibrillation||15 or 20 mg once daily with food|
|Treatment of DVT and/or PE||15 mg twice daily with food for first 21 days, followed by 20 mg once daily with food for remaining treatment|
|Reducing risk of DVT and/or PE recurrence in those at continued risk||10 mg once daily with or without food, after at least 6 months of standard anticoagulant therapy|
|Prevention of DVT following hip or knee replacement surgery||10 mg once daily with or without food|
|Prevention of venous thromboembolism (VTE) in acutely ill medical patients at risk for thromboembolic complications||10 mg once daily, with or without food, in hospital and after hospital discharge for total duration of 31 to 39 days|
|Coronary artery disease (CAD) or peripheral artery disease (PAD)||2.5 mg twice daily, with or without food, in combination with aspirin (75 or 100 mg) once daily|
Xarelto should not be used in children less than 6 months of age with any of the following: :
- Less than 37 weeks of gestation at birth
- Less than 10 days of oral feeding
- Body weight of less than 2.6 kg
Xarelto Side Effects
The most common adverse reaction in adult patients taking this medication was bleeding. In pediatric patients, the most common adverse reactions were bleeding, cough, vomiting, and inflamed stomach and gut.
Serious side effects that may be caused by Xarelto include:
- Increased risk of blood clots if you stop taking Xarelto
- Increased risk of having a stroke if you stop taking this medication
- Increased risk of bleeding if Xarelto is taken with other medications that increase your risk of bleeding, including:
- Aspirin or aspirin-containing products
- Long-term (chronic) use of non-steroidal anti-inflammatory drugs (NSAIDs)
- Warfarin (Coumadin, Jantoven)
- Any medicine that contains heparin
- Selective serotonin reuptake inhibitors (SSRIs, such as Prozac, Celexa, Lexapro) or serotonin norepinephrine reuptake inhibitors (SNRIs, such as Cymbalta, Effexor)
- Spinal or epidural (the space that surrounds the spinal cord) hematoma (blood clots)
It is important to contact your doctor or get immediate medical help if you or your child develop any of the following signs or symptoms of bleeding while taking Xarelto:
- Unexpected bleeding or bleeding that lasts a long time (eg, nosebleeds, gum bleeds, heavy menstrual bleeding)
- Bleeding that is severe that you cannot control
- Red, pink, or brown urine
- Bright red or black, tar-like stools
- Coughing up blood or blood clots
- Vomiting blood or vomit resembles coffee grounds
- Headaches, feeling dizzy or weak
- Pain, swelling, or new drainage at wound sites
The main precautions associated with Xarelto include the following:
- Risk of bleeding
- Pregnancy-related hemorrhage
- Xarelto use is not recommended in patients with prosthetic heart valves
- Xarelto use is not recommended in patients with Triple Positive Antiphospholipid Syndrome (associated with higher risk of blood clot formation)
If you experience back pain, tingling, numbness, muscle weakness (especially in legs and feet), or loss of control of bowels or bladder (incontinence), you should contact your doctor immediately.
Xarelto Forms and Strengths
Xarelto is available as a tablet and as an oral suspension for children.:
- Xarelto film-coated tablet
- Xarelto for Oral Suspension, 1mg/mL (amber glass bottle with two dosing syringes)
What if I miss a dose of Xarelto?
If you forget to take a dose of XARELTO, take it as soon as you remember on the same day.
Is it ok to stop taking Xarelto if I stop having any symptoms and start feeling better?
Do not discontinue Xarelto without consulting the doctor who prescribed Xarelto for you. . Prematurely stopping any oral anticoagulant, including Xarelto, increases your risk of developing blood clots and having a stroke.