Rivaroxaban

Sounds like 'RIV-a-ROX-a-ban'

Easy-to-read medicine information about rivaroxaban – what is it, how to take rivaroxaban safely and possible side effects.

Type of medicine Also called
  • Belongs to a groups of medicines known as anticoagulants that prevent blood clots
  • Xarelto®

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.

Dose

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 twice a day for 3 weeks, and then
20 mg once a day
  • Your dose may be lower if you have other medical conditions such kidney problems.
  • If you have had knee or hip surgery, you will need to take rivaroxaban for 2 to 5 weeks.
  • If you are taking it for other reasons, you will need to take it for longer.
  • Don't stop taking rivaroxaban until your doctor tells you to. Stopping too early can put you at greater risk of getting blood clots or stroke. 

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 dose

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:  
Notes:


 

How to take rivaroxaban

  • 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.
  • Rivaroxaban is best taken with food although the lower strength tablet (10 milligrams), can be taken without food. For the higher strength tablets (15 milligrams and 20 milligrams), more of the dose is absorbed when there is food in your stomach.    
  • Take your rivaroxaban dose at the same times each day. 
  • 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 TWICE 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.  
  • 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.

Possible side effects

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.

Increased risk of bleeding

Rivaroxaban increases your risk of bleeding. You might bleed or bruise more easily while you are taking rivaroxaban.

Injuries or falls

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

If you have any of the following signs of bleeding, contact your doctor immediately or ring Healthline for free 24hr health advice 0800 611 116

  • becoming pale, very weak and tired, or short of breath
  • any bleeding from the gums, cuts or nosebleeds that won’t stop
  • blood in the stools (poo) – black, tarry stools
  • blood in the urine (wee) – pink, red or brown-coloured urine
  • heavy periods (menstrual bleeding)
  • coughing up blood or vomit that looks like coffee grounds.

Interactions

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. 

Learn more

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 (Māori) New Zealand Formulary Patient Information
Xarelto® Medsafe Consumer Information Sheet (NZ)
Rivaroxaban Patient Info, UK

References

  1. Rivaroxaban: a fully-subsidised oral anticoagulant. BPAC, 2018
  2. An update on managing patients with atrial fibrillation BPAC, 2017
  3. Rivaroxaban New Zealand Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 19 Jul 2018