Xarelto (Rivaroxaban)

Xarelto is designed to prevent and treat blood clots. It belongs to a class of drugs known as direct oral anticoagulants (DOACs).

Patients with atrial fibrillation (an irregular heartbeat) are treated with Xarelto to minimize the risk of stroke and blood clots.

Xarelto (rivaroxaban) is a versatile anticoagulant used to prevent and treat various blood clot-related conditions. Most commonly, this includes:

• Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): The medication helps to reduce the risk of clots in the legs and lungs and prevent existing clots from growing.
• Stroke Prevention in Atrial Fibrillation: AFib is an irregular and often rapid heart rhythm that can cause blood to pool in the heart’s upper chambers. This pooled blood can form clots that may travel to the brain, causing a stroke. Xarelto reduces this risk by preventing the formation of these potentially dangerous blood clots.

The active ingredient in Xarelto is rivaroxaban.

Rivaroxaban works by directly inhibiting Factor Xa, a key protein in the blood clotting cascade.

Blockage of Factor Xa reduces the production of thrombin, which, in turn, reduces the formation of fibrin, the protein that forms the mesh of a blood clot.1 This ultimately reduces the blood’s ability to clot, thus lowering the risk of harmful blood clots forming.

Always follow your doctor’s instructions regarding the Xarelto regimen and ask them any questions about the treatment you may have. The following instructions are general and may differ slightly depending on your specific situation.

1. Xarelto tablets can be taken with or without food, except for the 15mg and 20mg doses, which should be taken with food.
2. Swallow the tablets whole with a drink of water. If swallowing pills is difficult, talk to your doctor or pharmacist, as there may be alternative ways to take the medication.
3. Take Xarelto at approximately the same time each day.
4. Do not stop taking Xarelto on your own accord. Talk to your doctor if you want to stop the treatment or if you have an upcoming surgical procedure.

Your doctor will determine the appropriate dosage based on your specific condition. Dosages vary depending on whether Xarelto is being used to prevent stroke in atrial fibrillation, treat DVT/PE, prevent DVT after surgery, or for other cardiovascular conditions.

General Dosage Guidelines for Adults:

• Stroke Prevention in Atrial Fibrillation:
  • If your CrCl is above 50 mL/min: 20 mg once daily with your evening meal.
  • If your CrCl is 50 mL/min or lower: 15 mg once daily with your evening meal.
• Treatment of DVT/PE:
  • If your CrCl is 15 mL/min or higher: 15 mg with food twice daily for 3 weeks, then 20 mg once daily.
• Prevention of Recurrent DVT/PE:
  • If your CrCl is 15 mL/min or higher: 10 mg once daily (after at least 6 months of initial treatment). Can be taken with or without food.
• Prophylaxis of DVT After Hip or Knee Replacement:
  • If your CrCl is 15 mL/min or higher: 10 mg once daily. Can be taken with or without food.
  • Start 6-10 hours after surgery, once bleeding is controlled.
  • Hip replacement: Continue for 35 days.
  • Knee replacement: Continue for 12 days.
• Prevention of VTE in Acutely Ill Medical Patients:
  • If your CrCl is 15 mL/min or higher: 10 mg once daily. Can be taken with or without food.
  • Continue in the hospital and after discharge for a total of 31 to 39 days.
• Reduction of Cardiovascular Events in CAD:
  • 2.5 mg twice daily, plus low-dose aspirin (75-100 mg once daily). Can be taken with or without food.
• Reduction of Thrombotic Events in PAD:
  • 2.5 mg twice daily, plus low-dose aspirin (75-100 mg once daily). Can be taken with or without food.

Source: https://www.drugs.com/dosage/xarelto.html

• Bleeding Risk: Xarelto increases the risk of bleeding, which can be serious and potentially fatal.
• Thrombotic Events: Discontinuing the medication in patients without adequate alternative anticoagulation increases the risk of thrombotic events.
• Spinal/Epidural Hematomas: Spinal or epidural hematomas may occur in patients undergoing neuraxial anesthesia or spinal puncture, which can result in long-term or permanent paralysis.
• Medical Conditions: Xarelto should not be used in patients with artificial heart valves. Certain medical conditions, such as liver or kidney disease, bleeding disorders, and recent major injury/surgery, may require caution or dosage adjustments.
• Allergic reactions: You may contact us and speak with one of our pharmacists or doctors if you have allergies before taking rivaroxaban. Inactive ingredients in this product may cause allergic reactions or other problems. For more information, contact us, and we will connect you with one of our licensed pharmacists.
• Alcohol Consumption: Regular alcohol consumption can increase the risk of stomach bleeding when taking Xarelto. It’s important to limit alcohol intake and consult your doctor about safe consumption levels.
• Fall Risk and Injury Prevention: Falls can be particularly dangerous while taking Xarelto, especially for older adults. Take steps to minimize fall hazards. To minimize bleeding risks, be extra careful when using sharp objects like razors or knives, and avoid activities where injuries are more likely.

Your doctor should be consulted before stopping Xarelto. Blood clots and strokes can occur if you suddenly stop taking it.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• cancer,
• liver disease,
• kidney disease,
• bleeding problems (such as bleeding of the stomach/intestines, swelling in the brain),
• stroke,
• artificial heart valves,
• recent major injury/surgery,
• blood disorders (such as anemia, hemophilia, thrombocytopenia),
• frequent falls/injuries,
• certain eye problems (retinopathy),
• specific clotting disease (antiphospholipid syndrome),
• certain hereditary enzyme problems (such as galactose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption).

Mild Side Effects:

• Easy bruising
• Dizziness
• Heavier menstrual periods
• Minor bleeding from gums
• Occasional nosebleeds

Major Side Effects:

• Severe or uncontrolled bleeding (e.g., vomiting blood, black or tarry stools, coughing up blood)
• Spinal or epidural hematomas (signs may include back pain, numbness, tingling, muscle weakness, or bowel/bladder dysfunction)
• Allergic reactions (e.g., skin rash, itching, swelling, difficulty breathing)
• Stomach bleeding (especially with regular alcohol use)

It is essential to call your doctor as soon as possible if you or your child experience bleeding symptoms such as headaches, dizziness, severe bleeding gums, nosebleeds, heavy menstrual periods, abnormal vaginal bleeding, blood in your urine, bloody or tarry stools, coughing up blood, vomit that looks like coffee grounds, or bleeding that won’t stop.

There are certain medications and substances that can interact with Xarelto. Those would include:

• Other Anticoagulants: Combining Xarelto with other blood thinners like warfarin (Coumadin, Jantoven), heparin, enoxaparin (Lovenox), or dabigatran (Pradaxa) significantly increases the risk of bleeding.
• Antiplatelet Medications: These medications, such as aspirin, clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta), also prevent blood clotting. Taking them with Xarelto can further increase bleeding risk.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) can also increase bleeding risk, especially when combined with Xarelto.
• Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Some antidepressants in these classes may increase bleeding risk when taken with Xarelto.2

This is not an exhaustive list, and other medications may interact with Xarelto. Always inform your doctor about medications and supplements you are taking, including over-the-counter drugs and herbal remedies.

Children and pets should not be allowed to access this product.

The product should be stored at room temperature between 20 and 25 degrees Celsius (68 and 77 degrees Fahrenheit). After the expiration date, dispose of any unused medication.

When you order Xarelto from Insulin Outlet, you can be confident you’re receiving safe, authentic medication. We partner with reputable, licensed Canadian pharmacies that meet all federal standards. This ensures you get the same Xarelto, approved by Health Canada, as you would in the US, with only packaging differences. Experience significant savings and convenient, secure delivery right to your door. Order online or call us today!

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