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Xarelto (rivaroxaban) 

Indications

Xarelto is used for: 

• Lowering the risk of stroke and blood clots in people with irregular heartbeats (not caused by heart valve problems). 
• Treating blood clots in the legs (deep vein thrombosis, DVT). 
• Treating blood clots in the lungs (pulmonary embolism, PE). 
• Reducing the chance of blood clots coming back after treatment for DVT or PE. 
• Preventing blood clots in people having knee or hip replacement surgery. 
• Preventing blood clots in seriously ill patients. 
• Lowering the risk of major heart problems in people with coronary artery disease (CAD). 
• Lowering the risk of serious blood vessel problems in people with peripheral artery disease (PAD), including after recent surgery on leg arteries. 
• Treating and preventing blood clots in children from birth to under 18 years old. 
• Preventing blood clots in children 2 years and older with congenital heart disease after the Fontan procedure. 

Dosage and Administration

• Take Xarelto exactly as prescribed by your doctor. 
• Swallow the tablet whole with water. 
• Take Xarelto with food if prescribed a dose of 15 mg or more. If you miss a dose and are taking Xarelto once daily, take it as soon as you remember on the same day. 
• Do not change your dose or stop taking Xarelto unless your doctor tells you to. 
• Do not stop taking Xarelto without first talking to your doctor. 
• Do not take more than the prescribed dose. 
• Do not take Xarelto if you have active bleeding or severe hypersensitivity reactions to the drug. 

Mechanism of Action

Xarelto works by inhibiting Factor Xa, an essential enzyme in the blood coagulation process. By blocking Factor Xa, Xarelto reduces the formation of blood clots, which helps prevent conditions like strokes, deep vein thrombosis, and pulmonary embolism. 

Contraindications

• Active pathological bleeding 
• Severe hypersensitivity reaction to Xarelto 

Side Effects

Common Side Effects: 

• Bleeding complications 
• Bruising 
• Nausea 
• Muscle pain 

Serious Side Effects: 

• Severe bleeding 
• Allergic reactions (rash, itching, swelling) 
• Liver enzyme abnormalities 

Precautions

• Be aware that Xarelto can lead to serious and potentially fatal bleeding. There’s an agent available to reverse its effects if needed. 
• If you’re pregnant, use Xarelto cautiously because it could increase the risk of obstetric hemorrhage and emergent delivery.  
• It’s not recommended to use Xarelto if you have prosthetic heart valves. 
• If you have triple positive antiphospholipid syndrome, it’s not recommended to use Xarelto because it may increase the risk of thrombosis. 

Storage Instructions

• Store Xarelto tablets at room temperature between 68°F to 77°F (20°C to 25°C). 
• Keep the tablets in their original packaging until they are ready to use. 
• Protect from moisture and light. 

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/215859s000lbl.pdf