Uses
What is Xarelto used for?
Xarelto (rivaroxaban) is commonly used for the following conditions.
- Prevention of stroke and blood clots in people with a certain type of irregular heartbeat, called atrial fibrillation, that is not caused by a heart valve problem
- Prevention of blood clots in people after knee or hip replacement surgery, or in certain people who are hospitalized or recently discharged from the hospital and are at risk of a blood clot
- Treatment of blood clots in your legs (deep vein thrombosis or DVT) or lungs (pulmonary embolism or PE)
- Reducing the risk of another blood clot after treating a previous blood clot
- Reducing the risk of heart attack and stroke in people with coronary artery disease (CAD)
- Reducing the risk of decreased blood flow to the legs, amputations, serious heart problems, and stroke in people with peripheral artery disease (PAD)
- Treatment and prevention of blood clots in certain children
- Prevention of blood clots in children with congenital heart disease after a certain heart surgery (Fontan procedure)
Xarelto may also be used for other conditions as determined by your healthcare provider.
How does Xarelto work (mechanism of action)?
Xarelto is a blood thinner that works on a protein in your body, factor Xa, to keep your blood from clotting.
How is Xarelto supplied (dosage forms)?
Brands and other names
- Xarelto
Dosage forms and strengths
- 1 mg/mL for oral suspension
- 2.5 mg oral tablets
- 10 mg oral tablets
- 15 mg oral tablets
- 20 mg oral tablets
How should I store Xarelto?
Xarelto should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Do not freeze the oral liquid and throw it away after the “Discard after” date written on the bottle.
Side Effects
What are the most common side effects of Xarelto?
The most common side effects of Xarelto are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Bleeding (see below)
- Cough (children)
- Vomiting (children)
- Inflamed stomach and gut (children)
There may be other side effects of Xarelto that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of Xarelto?
While less common, the most serious side effects of Xarelto are described below, along with what to do if they happen.
Severe Allergic Reactions. Xarelto may cause allergic reactions, which can be serious. Stop taking Xarelto and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Severe Bleeding. Xarelto can increase your risk of severe bleeding that can lead to death. Some patients with serious bleeding may need a blood transfusion or surgery. Call your healthcare provider right away if you have any of the following signs of severe bleeding while taking Xarelto.
- Unexpected bleeding or bleeding that lasts a long time, including nosebleeds or gum bleeding
- Red, pink, or brown urine (pee)
- Bright red or black stools (looks like tar)
- Coughing up blood or blood clots
- Vomiting blood (may look like coffee grounds)
- Headaches or feeling dizzy
- Pain or swelling around wounds
Warnings & Precautions
Who should not use Xarelto?
Allergies to Ingredients. People who are allergic to any of the following should not take Xarelto.
- Xarelto
- Rivaroxaban
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in Xarelto.
Unusual Bleeding. Do not take Xarelto without talking to your healthcare provider if you have any abnormal or unusual bleeding.
What should I know about Xarelto before using it?
Do not take Xarelto unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share Xarelto with other people, even if they have the same condition as you. It may harm them.
Keep Xarelto out of the reach of children.
Do not stop taking or change your dose of Xarelto unless your healthcare provider tells you to do so. Stopping Xarelto before completing the course prescribed by your healthcare provider can result in blood clots.
Do not split Xarelto tablets. If you cannot swallow the tablets whole, they may be crushed and mixed with applesauce. Take the mixture right away. Do not save it for a future dose. If you are giving Xarelto through a feeding tube, ask your healthcare provider for instructions.
If you or your child is prescribed Xarelto oral liquid, use the syringes provided in the original carton to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose.
People who are 65 years and older can be at greater risk for some side effects from Xarelto. Talk to your healthcare provider about your risks if you are in this age group.
What should I tell my healthcare provider before using Xarelto?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Xarelto is right for you.
Current and Past Health Conditions. Tell your healthcare provider if you have or have had any of the following.
- Bleeding problems
- Kidney or liver problems
- A prosthetic heart valve
- A clotting problem called antiphospholipid syndrome (APS)
Planned Procedures. Tell all of your healthcare providers that you or your child are taking Xarelto. Talk to the healthcare provider who prescribed Xarelto to find out whether you should stop taking it before you have any surgery, medical, or dental procedure.
Other Medicines and Supplements. Xarelto may interact with other medicines and supplements. Before taking Xarelto, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how Xarelto could affect pregnancy or harm an unborn baby. Xarelto may increase the risk of bleeding for you or your unborn baby. Tell your healthcare provider right away if you are or plan to become pregnant. Your healthcare provider will advise you if you should take Xarelto while you are pregnant or trying to get pregnant. If you have any signs of bleeding or blood loss during pregnancy, tell your healthcare provider right away.
Breastfeeding. Xarelto can pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take Xarelto while breastfeeding.
How can I get more information about Xarelto?
For more information about Xarelto, you can visit the manufacturer’s website at www.xarelto-us.com or call them at 888-XARELTO.
Interactions
Does Xarelto interact with foods or drinks?
You may take Xarelto 2.5 mg and 10 mg oral tablets with or without food. Take Xarelto 15 mg or 20 mg tablets with food. Ask your pharmacist or other healthcare provider if you or your child should take Xarelto oral liquid with food, since it depends on the dose.
Grapefruit and grapefruit juice may increase Xarelto levels and the risk of bleeding and other side effects.
It is unknown if drinking alcohol will affect Xarelto, but both Xarelto and alcohol can increase your risk of bleeding. It is best to limit the amount of alcohol you drink.
Does Xarelto interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking Xarelto.
- Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
- A blood thinner, such as warfarin or enoxaparin, which is a medicine used to treat or prevent blood clots
- An antiplatelet medicine, such as clopidogrel (Plavix), ticagrelor (Brilinta), aspirin/dipyridamole, or cilostazol, which is a medicine used to prevent blood clots
- A medicine used to control your heart rate or rhythm (antiarrhythmic)
- A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
- A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
- A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
- Ketoconazole, a medicine used for fungal infections
- A medicine for HIV, AIDS, or hepatitis C
- A macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
- A medicine for seizures, such as carbamazepine, phenytoin, or phenobarbital
- St. John’s wort, which is a supplement that may be used to treat depression
- Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
Many other medicines may alter the blood levels of Xarelto. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with Xarelto. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much Xarelto?
If you or someone else has used too much Xarelto, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of Xarelto?
If you miss a dose of Xarelto, contact your pharmacist or other healthcare provider. Your instructions for how to handle a missed dose may vary depending on why you take Xarelto or your dosage.
Missing doses of Xarelto can put you at risk for blood clots. It is important not to miss or skip doses.
Are you currently using Xarelto (rivaroxaban)?
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