Rivaroxaban is an anticoagulant, which means it makes it less likely your blood will clot. Find out how to take it safely and possible side effects. Rivaroxaban is also called Xarelto.
|Type of medicine||Also called|
What is rivaroxaban?
Rivaroxaban is an anticoagulant or ‘blood thinner’. It slows down your body’s ability to clot blood. It is used to prevent and treat blood clots. Preventing blood clots helps lower your risk of stroke. You may be prescribed rivaroxaban:
- to prevent stroke, if you have atrial fibrillation (irregular heart beat). Atrial fibrillation increases your risk of stroke. Read more about atrial fibrillation.
- after hip or knee surgery when your risk of blood clots is increased.
- to treat deep vein thrombosis (DVT) – blood clots that form in the blood vessels, usually in the legs or arm. Read more about DVT.
- to prevent DVTs from forming again.
The following video is about the use of rivaroxaban in atrial fibrillation.
Credits: Bay of Plenty DHB
Rivaroxaban tablets are available in different strengths: 10 mg, 15 mg and 20 mg.
Your doctor or pharmacist will tell you the strength that is right for you. Your dose of rivaroxaban will depend on what it is being used for.
|Dose of rivaroxaban
|To prevent stroke in people with atrial fibrillation||20 mg once a day|
|To prevent clots after knee or hip surgery||10 mg once a day|
|To treat blood clots||15 mg two times a day for 3 weeks, and then
20 mg once a day
Always take your rivaroxaban exactly as your doctor has told you. The pharmacy label will tell you how much rivaroxaban to take, how often to take it and any special instructions.
|My rivaroxaban dose|
|I am taking rivaroxaban for - choose the option that applies to you:
□ Atrial fibrillation
□ After hip or knee surgery, to prevent clots
□ Deep vein thrombosis (DVT)
|My dose is:|
|For how long:|
How to take rivaroxaban
- Timing: Take your rivaroxaban dose at the same times each day. Rivaroxaban is best taken with food or during a meal, especially the higher strength tablets (15 milligrams and 20 milligrams). This is because more of the dose is absorbed when there is food in your stomach. The lower strength tablet (10 milligrams), can be taken without food.
- Swallow your tablets with a glass of water. If you can't swallow the tablet, you can crush it and mix it with a little water or apple puree, just before taking it.
- Missed dose: If you forget to take your dose, follow these instructions or contact your pharmacist or doctor.
- If you're taking rivaroxaban ONCE A DAY: if you miss a dose, take it as soon as you remember on the same day. Do not take double the dose – this increases your risk of bleeding
- If you're taking rivaroxaban 15 mg TWO TIMES A DAY: if you forget to take a dose; you can take two 15 mg tablets at the same time to get a total dose of 30 mg in one day. Continue your regular dose twice daily the next day.
- Tell your healthcare provider: It is important to let health professionals know that you are taking rivaroxaban such as your dentist, pharmacist, podiatrist or nurse. You may need to stop using this medicine for several days before having surgery, dental appointments or medical tests.
Precautions - before starting rivaroxaban
- Do you have stomach problems such as an ulcer?
- Are pregnant or breastfeeding?
- Have you have had any surgery recently (other than hip or knee surgery)?
- Do you have high blood pressure (hypertension)?
- Do you have any medical problems that may increase your risk of bleeding?
- Do you have problems with the blood vessels in your eyes (known as vascular retinopathy)?
- Do have any problems with your liver or kidneys?
- Do you have a long-term lung condition called bronchiectasis?
- Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines.
If so, it’s important that you tell your doctor or pharmacist before you start rivaroxaban. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Like all medicines, rivaroxaban can cause side effects, although not everyone gets them.
Common side effects include nausea (feeling sick), indigestion, tummy cramps and headache. These may go away with time. Tell your doctor if troublesome.
Rivaroxaban increases your risk of bleeding. You might bleed or bruise more easily while you are taking rivaroxaban.
- Be careful when shaving, clipping fingernails, brushing and flossing your teeth or playing sports.
- Avoid new tattoos and piercings while taking rivaroxaban; these things may cause bruising and bleeding.
- Minor bleeding should usually stop on its own.
- If you have a fall or hurt your head or body, get medical attention immediately, even if you feel okay.
|Signs of severe bleeding|
Contact your healthcare provider urgently if you have any of the following signs of bleeding:
Rivaroxaban should not be taken with some other medications and herbal supplements, so always check with your doctor or pharmacist before starting rivaroxaban or before starting any new medicines. Also check with your pharmacist before taking:
- over-the-counter anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), naproxen (e.g. Naprogesic)
- herbal extracts such as garlic, ginkgo or ginseng.
Taking these together with rivaroxaban may increase your risk of bleeding and should be avoided.
The following links provide further information on rivaroxaban. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.
- Rivaroxaban: a fully-subsidised oral anticoagulant. BPAC, 2018
- An update on managing patients with atrial fibrillation BPAC, 2017
- Rivaroxaban New Zealand Formulary