What is Xarelto Uses, warnings & interactions
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Xarelto is an anticoagulant medication given to adults (and children) to treat and reduce the risk of blood clots caused by various conditions, including coronary artery disease and pulmonary embolism.
If you have been prescribed Xarelto by your doctor, you may want to know more about what it is and how it works. Here we’ll explain what Xarelto is used for, how it works, its side effects, and more.
- Treatment of blood clots
- Factor Xa inhibitor
What is Xarelto used for?
Xarelto (rivaroxaban) is a prescription drug that is manufactured by Janssen Pharmaceuticals. There is no generic version of Xarelto available. It is approved by the FDA to:
- Reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (irregular heartbeat)
- Treat deep vein thrombosis (DVT), and pulmonary embolism (PE), and reduce the risk of recurrence of DVT and PE
- Prophylaxis of DVT, which may lead to PE in patients undergoing hip or knee replacement surgery
- Prophylaxis of venous thromboembolism (VTE) in acutely ill medical patients
- Reduce the risk of major cardiovascular events in patients with coronary artery disease (CAD)
- Reduce the risk of major thrombotic vascular events in patients with peripheral artery disease (PAD)
- Treatment of VTE and reduction in the risk of recurrent VTE in pediatric patients from birth to less than 18 years
- Thromboprophylaxis in pediatric patients 2 years and older with congenital heart disease after the Fontan procedure
How does Xarelto work?
Blood clotting is a complex process that helps prevent excessive bleeding when a blood vessel is injured. Sometimes they form in your body when they are not needed, which can block the flow of blood and lead to stroke or heart attack.
The active ingredient in Xarelto is called rivaroxaban. It’s an oral anticoagulant drug, or blood thinner, that reduces the likelihood of clots forming in your blood. It works by blocking an enzyme in your blood called factor Xa, which plays an important part in the blood clotting process. By blocking this enzyme, it reduces your risk of blood clots forming.
What are the most commonly prescribed doses of Xarelto?
- 2.5 mg tablet
- 10 mg tablet
- 15 mg tablet
- 20 mg tablet
- 1mg/ml oral suspension
How to take Xarelto
- Take Xarelto exactly as prescribed by your doctor. Do not change your dose or stop taking this medication unless instructed by your doctor.
- Xarelto is usually taken with an evening meal.
- Xarelto may need to be stopped for a few days before any surgery or medical or dental procedure. Your doctor will tell you when to stop taking Xarelto and when to start taking it again after your procedure.
- If you have trouble swallowing pills, you can crush Xarelto tablets and mix them with soft foods to eat, like applesauce, immediately before use.
- If you miss a dose of Xarelto while taking it twice a day, take it as soon as you remember on the same day. You may take 2 doses at the same time to make up for the missed dose. Take your next dose at your regularly scheduled time. If you are taking Xarelto once a day, take the missed dose as soon as you remember on the same day. Take your next dose at your regularly scheduled time.
- If you take too much Xarelto, go to the nearest hospital emergency room or call your doctor right away.
- Please read the full Prescribing Information, including Boxed Warnings, and the Medication Guide.
- Xarelto tablets and suspension should be stored at room temperature between 68°F to 77°F (20°C to 25°C) away from heat, direct light, and moisture. Store the syringes and bottle upright in the original carton for Xarelto suspension. Do not freeze the Xarelto suspension. Discard the Xarelto suspension after the “Discard after” date that is written on the bottle.
- Active pathological bleeding
- If you have had an allergic reaction to Xarelto
- Patients who have had an aortic valve replacement
- Epidural or spinal hematomas that can result in long-term or permanent paralysis.
- Stopping Xarelto too early increases your risk of heart-related problems, such as heart attack or stroke.
- Xarelto causes an increased risk of bleeding which can cause serious and life-threatening. A reversal agent of rivaroxaban is available.
- Xarelto should be used with caution in pregnant women due to the potential for pregnancy-related hemorrhage.
- Xarelto is not recommended for use in patients with prosthetic heart valves.
- Xarelto is not recommended for use in patients with Triple Positive Antiphospholipid Syndrome.
- Do not remove an indwelling epidural or intrathecal catheter until 18hr to 26hr have elapsed after the last administration. Do not administer the next dose until 6 hr after removal of the catheter.
- Tell your healthcare professional if you are pregnant or breastfeeding.
Xarelto can interact with other medications. These drug interactions can change how Xarelto and other medications work. They can also make some side effects more likely. You should tell your prescribing physician if you are taking any of the following prescription medications or over-the-counter (OTC) supplements:
- Prothrombin complex concentrate, human
- Factor X, human
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as Motrin (ibuprofen) and Aleve (naproxen)
- St. John’s Wort
Xarelto side effects
Serious side effects of Xarelto
- Excessive or unusual bleeding
- Spinal or epidural hematoma (bleeding around your spine)
- Tarry stools
- Vomiting blood or your vomit looks like coffee grounds
- Bruising that lasts longer than normal
Common side effects of Xarelto
- Back pain
- Heavy menstrual bleeding
- Muscle spasms
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Learn more about Xarelto versus other anticoagulant medications which vary by different factors such as side effects and costs. The following FDA-approved alternatives to Xarelto are available:
- Eliquis (apixaban)
- Coumadin (warfarin)
- Plavix (clopidogrel)
Is Xarelto better than Coumadin?
Compared to Coumadin (warfarin), Xarelto results in less major bleeding or brain hemorrhage but slightly more stomach bleeding. Xarelto is also more convenient. There are no blood tests required to check your levels, no dietary restrictions, and fewer drug interactions.
As far as efficacy is concerned, your risk of stroke with atrial fibrillation is lower on Xarelto than on Coumadin.
The other major difference is cost. Xarelto is far more expensive than Coumadin. NiceRx helps eligible individuals enroll for Xarelto patient assistance to help lower the cost of Xarelto.
How long does Xarelto last?
The maximum concentration of Xarelto appears 2 to 4 hours after taking the tablet and will typically last around 24 hours.
How long does Xarelto stay in the system?
Its half-life is 5 to 9 hours so it will take approximately 25 to 45 hours to completely clear your bloodstream.
Does Xarelto cause withdrawal?
Xarelto does not cause withdrawal but if you stop treatment too early, you are at an increased risk of cardiovascular problems, such as heart attack or stroke.
How do I store Xarelto?
Xarelto tablets and suspension should be stored at room temperature between 68°F to 77°F (20°C to 25°C) away from heat, direct light, and moisture. Store the syringes and bottle upright in the original carton for Xarelto suspension. Do not freeze the Xarelto suspension. Discard the Xarelto suspension after the “Discard after” date that is written on the bottle.
How long does it take for Xarelto to kick in and start working?
It takes 2 to 4 hours for Xarelto to reach its full blood-thinning effect.
Is there a generic for Xarelto?
Currently, there is not a generic for Xarelto available on the market. However, you can still save on brand-name drugs like Xarelto through NiceRx.