Rivaroxaban

This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Xarelto; Xarelto Starter Pack

Brand Names: Canada

APO-Rivaroxaban; PMS-Rivaroxaban; PRO-Rivaroxaban; REDDY-Rivaroxaban; RIVA-Rivaroxaban; SANDOZ Rivaroxaban; TARO-Rivaroxaban; TEVA Rivaroxaban; Xarelto

Warning

  • Do not stop taking this drug without talking to your doctor. Stopping this drug before you are supposed to may raise the chance of blood clots. If you need to stop this drug, your doctor will tell you how.
  • People who have any type of spinal or epidural procedure are more likely to have bleeding problems around the spine when already on this drug. This bleeding rarely happens, but can lead to not being able to move body (paralysis) long-term or paralysis that will not go away. The risk is raised in people who have problems with their spine, a certain type of epidural catheter, or have had spinal surgery. The risk is also raised in people who take any other drugs that may affect blood clotting, like blood-thinner drugs (like warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
  • Tell your doctor you use this drug before you have a spinal or epidural procedure. Call your doctor right away if you have any signs of nerve problems like back pain, numbness or tingling, muscle weakness, paralysis, or loss of bladder or bowel control.
  • Talk with your doctor if you have recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of this drug and your procedure. Talk with your doctor.

What is this drug used for?

  • It is used to treat or prevent blood clots.
  • It is used to lower the chance of heart attack, stroke, and death in some people.
  • It is used to lower the chance of lowered blood flow to the legs, amputation, and severe heart problems in some people.

Granules for oral suspension:

  • This form of this drug is not approved for use in adults. However, your doctor may decide the benefits of taking this drug outweigh the risks. If you have been given this form of this drug, ask your doctor for information about the benefits and risks. Talk with your doctor if you have questions about taking this drug.

What do I need to tell my doctor BEFORE I take this drug?

  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have bleeding problems.
  • If you have any of these health problems: Kidney disease or liver disease.
  • If you have had or plan to have a heart valve replaced.
  • If you have antiphospholipid syndrome (APS).
  • If you take any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for HIV, infections, or seizures. There are many drugs that must not be taken with this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. This drug may need to be stopped before certain types of surgery as your doctor has told you. If this drug is stopped, your doctor will tell you when to start taking this drug again after your surgery or procedure.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor. Rarely, some bleeding problems have been deadly.
  • If you fall or hurt yourself, or if you hit your head, call your doctor right away. Talk with your doctor even if you feel fine.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.
  • Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Dizziness or passing out.
  • Very bad headache.
  • Pain, swelling, or new drainage at wound sites.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

  • Pain in arms or legs.
  • Feeling tired or weak.
  • Cough.
  • Throwing up.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to your national health agency.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

2.5 mg and 10 mg doses:

  • Take with or without food.

15 mg and 20 mg doses:

  • Take with food.

All doses:

  • Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
  • If you cannot swallow tablets, the tablet may be crushed and mixed with applesauce. Take within 4 hours of mixing.
  • If your dose is 15 mg or 20 mg, eat some food right after taking a crushed tablet.
  • Those who have feeding tubes may use this drug. Use as you have been told. Flush the feeding tube after this drug is given.

What do I do if I miss a dose?

15 mg twice daily dosing:

  • Take missed dose right away to make sure you get 30 mg in one day. You may take 2 tablets at the same time. Then go back to your normal times the next day.
  • If you do not think about the missed dose until the next day, skip the missed dose and go back to your normal time.

2.5 mg twice daily dosing:

  • Skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

All other dosing:

  • Take a missed dose as soon as you think about it on the same day you missed the dose.
  • If you do not think about the missed dose until the next day, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

For all patients taking this drug:

  • If you are not sure what to do if you miss a dose, call your doctor.

How do I store and/or throw out this drug?

  • Store at room temperature in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-01-07

Copyright

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Last Updated

Monday, December 12, 2022