Generic Name: rivaroxaban, Oral tablet

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SECTION 1 of 4

Highlights for rivaroxaban

Oral tablet
1

Rivaroxaban is an oral drug used to treat and prevent blood clots in your body. It also helps to reduce your risk of stroke if you have the heart condition atrial fibrillation without an artificial heart valve.

2

The most common side effect is bleeding. Some bleeds may be serious and even fatal. You may bruise more easily, and it may take longer than usual for bleeding to stop. This happens because rivaroxaban is a blood thinner drug that decreases the chance of blood clots.

3

Don’t stop taking rivaroxaban without talking to your doctor first. When you stop taking a blood thinner, you’re likely to form a clot or have a stroke.

4

Rivaroxaban may need to be stopped before surgery or a medical or dental procedure. Your doctor will let you know when to stop taking the drug and when to start taking it again. If you have to stop taking it, your doctor may prescribe another medicine to help prevent blood clots from forming.

IMPORTANT INFORMATION

FDA Warning

  • Warning for stopping treatment: Don’t stop taking rivaroxaban without talking to your doctor first. When you stop taking a blood thinner, you’re likely to form a clot or have a stroke.
  • Spinal or epidural blood clots (hematoma) warning: People who take a blood thinner like rivaroxaban, and have another medicine injected into their spinal and epidural area, or have a spinal puncture, have a risk of forming a severe blood clot. This can cause long-term or permanent paralysis. Your risk is higher if:
    • a thin tube (epidural catheter) is placed in your back to give you medicine
    • you take nonsteroidal anti-inflammatory drugs (NSAIDs) or another medicine to prevent your blood from clotting
    • you have a history of epidural or spinal punctures
    • you have a history of problems with your spine or have had surgery on your spine
    If you take this drug and receive spinal anesthesia or have a spinal puncture, your doctor should watch you for symptoms of spinal or epidural blood clots. Tell your doctor right away if you have the following symptoms:
    • pain, tingling, or numbness
    • muscle weakness, especially in your legs and feet
    • loss of control of the bowels or bladder (incontinence)

Risk of bleeding

Rivaroxaban may cause serious bleeding that can be fatal in rare cases. This happens because rivaroxaban is a blood thinner medicine that reduces blood clotting. While you take this drug, you may bruise more easily, and it may take longer for bleeding to stop. You may have a higher risk if you also take other medicines that increase your risk of bleeding, including:

  • aspirin or products that contain aspirin
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • warfarin sodium (Coumadin, Jantoven)
  • medicine that contains heparin
  • clopidogrel (Plavix)
  • other medicines that prevent or treat blood clots

Tell your doctor about all medicines that you take. Call your doctor or get medical help right away if you have any of these signs of bleeding:

  • unexpected bleeding or bleeding that lasts a long time, such as:
    • frequent nosebleeds 
    • unusual bleeding from your gums
    • menstrual bleeding that is heavier than normal
  • bleeding that is severe or that you can’t control
  • red, pink, or brown-colored urine
  • bright red or black-colored stools that look like tar
  • coughing up blood or blood clots
  • vomiting blood or vomit that looks like coffee grounds
  • headaches, dizziness, or weakness
  • pain, swelling, or new drainage at wound sites

Artificial heart valve risk

Don’t take rivaroxaban if you have an artificial (prosthetic) heart valve. Rivaroxaban hasn’t been studied in patients with artificial heart valves.

Surgery or procedure warning

You may need to temporarily stop taking rivaroxaban before any surgery or medical or dental procedure. Your doctor will let you know when to stop taking the drug and when to start taking it again. Your doctor may prescribe another medicine to help prevent blood clots from forming.

Drug Features

Rivaroxaban is a prescription drug. It’s available as an oral tablet.

Why It's Used

Rivaroxaban is a blood thinner that is used to prevent stroke and prevent and treat blood clots in your blood vessels (thrombosis). These blood clots often form in certain veins in your legs (deep vein thrombosis). Sometimes the blood clots move to your lungs where they get stuck and block the flow of your blood (pulmonary embolism).

More Details

How It Works

Rivaroxaban belongs to a class of drugs called anticoagulants, specifically factor Xa inhibitors (blockers). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

Why It's Used

Rivaroxaban is a blood thinner that is used to prevent stroke and prevent and treat blood clots in your blood vessels (thrombosis). These blood clots often form in certain veins in your legs (deep vein thrombosis). Sometimes the blood clots move to your lungs where they get stuck and block the flow of your blood (pulmonary embolism). If you have atrial fibrillation, your heart doesn’t beat the way it should. This puts you at higher risk for these blood clots. This drug can help reduce that risk. Your doctor may also have you use this drug if you have had hip or knee replacement surgery. These conditions also put you at higher risk of these blood clots.

How It Works

Rivaroxaban belongs to a class of drugs called anticoagulants, specifically factor Xa inhibitors (blockers). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Rivaroxaban helps prevent blood clots from forming by blocking a substance known as factor Xa. This is a factor that’s needed for your blood to clot. When drugs like rivaroxaban block factor Xa, it decreases the amount of an enzyme called thrombin. Thrombin is a substance in your blood that’s needed to form clots. Thrombin also causes platelets in your blood to stick to one another, causing clots to form. When thrombin is decreased, this prevents a clot (thrombus) from forming in your body.

SECTION 2 of 4

rivaroxaban Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with rivaroxaban include:

  • bleeding. This includes:

    • bruising more easily
    • bleeding that takes longer to stop

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • severe bleeding. Symptoms may include:

    • unexpected bleeding or bleeding that lasts a long time, such as:
      • frequent nosebleeds
      • unusual bleeding from your gums
      • menstrual bleeding that is heavier than normal
    • bleeding that is severe or that you can’t control
    • red, pink, or brown-colored urine
    • bright red or black stools that look like tar
    • coughing up blood or blood clots
    • vomiting blood or vomit that looks like coffee grounds
    • pain, swelling, or new drainage at wound sites
  • spinal or epidural blood clots (hematoma). People who take rivaroxaban and have another medicine injected into their spinal and epidural area, or have a spinal puncture, have a risk of forming a severe blood clot. This can cause long-term or permanent paralysis. Symptoms may include:

    • pain, tingling, or numbness
    • muscle weakness, especially in your legs and feet
    • loss of control of the bowels or bladder (incontinence)
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Rivaroxaban doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

rivaroxaban May Interact with Other Medications

Oral tablet

Rivaroxaban can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Non-steroidal anti-inflammatory drugs (NSAIDs)

Examples are:

  • diclofenac (Voltaren-XR)
  • etodolac
  • fenoprofen (Nalfon)
  • flurbiprofen
  • ibuprofen (Motrin)
  • indomethacin (Indocin)
  • ketoprofen
  • ketorolac
  • meclofenamate
  • mefenamic acid (Ponstel)
  • meloxicam (Mobic)
  • nabumetone
  • naproxen (Naprosyn)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)
  • sulindac
  • tolmetin

Use caution when taking rivaroxaban with NSAIDs. Taking these medications together may increase your chance for bleeding, because they both prevent your blood from clotting.

Antiplatelet drugs
  • clopidogrel (Plavix)

Use caution when taking antiplatelet drugs with rivaroxaban. Both of these medications work to decrease your blood from clotting. If you take them together, your blood may become too thin and you may be more likely to bleed.

Aspirin

Use caution when taking aspirin with rivaroxaban. Both of these medications work to decrease your blood from clotting. If you take them together, your blood may become too thin and you may be more likely to bleed.

Blood thinners

Examples are:

  • warfarin sodium (Coumadin, Jantoven)
  • heparin

Don’t take rivaroxaban with these blood thinners. Both anticoagulant drugs and rivaroxaban work to decrease your blood from clotting. If you take these medications together, your blood may become too thin and you may be more likely to bleed.

Medications to treat human immunodeficiency virus (HIV)

Examples are:

  • atazanavir (Reyataz)
  • darunavir (Prezista)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • lopinavir/ritonavir (Kaletra)
  • nelfinavir (Viracept)
  • ritonavir (Norvir)
  • saquinavir (Invirase)
  • tipranavir (Aptivus)

Don’t take rivaroxaban with a certain class of medications called protease inhibitors because they increase the blood levels of rivaroxaban. If the blood levels are increased, your blood may become too thin and you may be more likely to bleed.

Antifungal drugs

Examples are:

  • ketoconazole (Nizoral)
  • itraconazole (Omnel, Sporanox)

When these drugs are taken together, the blood levels of rivaroxaban increase. This may make your blood too thin and you may be more likely to bleed. Don’t take these drugs with rivaroxaban.

Tuberculosis drugs

Examples are:

  • rifampin (Rifater, Rifamate, Rimactane, or Rifadin)
  • rifabutin (Mycobutin)
  • rifapentine (Priftin)

Don’t take ribaroxaban with these drugs. They may reduce the blood levels of rivaroxaban and make it less effective.

Herbal supplement
  • St. John’s wort (Hypericum perforatum)

Don’t take rivaroxaban with St. John’s Wort. It may reduce the blood levels of rivaroxaban and make it less effective.

Seizure drugs

Examples are:

  • carbamazepine (Carbatrol, Equetro, Tegretol, Tegretol XR, Epitol)
  • ethotoin (Peganone)
  • fosphenytoin (Cerebyx)
  • phenytoin (Dilantin)

Don’t take these drugs together. They may reduce the blood levels of rivaroxaban and make it less effective.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with bleeding problems

If you have abnormal bleeding, don’t take rivaroxaban. This drug is a blood thinner and may increase your risk for serious bleeding. Talk to your doctor if you have unusual bleeding.

People with liver problems

You shouldn’t take rivaroxaban if you have moderate to severe liver disease or liver disease associated with bleeding problems. If you have liver problems, your body may not be able to clear rivaroxaban from your body well. This can cause the drug to build up in your body, which may put you at risk for bleeding.

People with kidney problems

You may need a lower dose of this drug or you may not be able to take it at all. If your kidneys aren’t working right, your body won’t be able to clear out the drug as well. This can cause the drug to build up in your body, which may put you at risk for bleeding.

People with artificial heart valves

Don’t take rivaroxaban if you have an artificial (prosthetic) heart valve. Rivaroxaban hasn’t been studied in patients with artificial heart valves.

SECTION 4 of 4

How to Take rivaroxaban (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Prevent stroke and blood clots in people with atrial fibrillation who don’t have artificial heart valves
Form: Oral tablet
Strengths: 10 mg, 15 mg, and 20 mg

Your dose of rivaroxaban depends on how well your kidneys are working.

Adult Dosage (ages 18 years and older)

Take 20 mg once per day with dinner.

Child Dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years old.

Special Considerations

Kidney problems:

  • Moderate to severe kidney problems: 15 mg taken once per day with dinner.
  • Very severe kidney problems: This drug shouldn’t be used.

Treat blood clots in the legs (deep vein thrombosis or DVT) or lungs (pulmonary embolism or PE)
Form: Oral tablet
Strengths: 10 mg, 15 mg, and 20 mg

Your dose of rivaroxaban depends on how well your kidneys are working.

Adult Dosage (ages 18 years and older)
  • For the first 21 days of treatment, the dosage is 15 mg taken two times per day with food.
  • For the rest of your treatment, the dosage is 20 mg taken once per day with food.
Child Dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years old.

Special Considerations

Kidney problems: Severe kidney problems: This drug shouldn’t be used.

Prevent blood clots in the legs (deep vein thrombosis or DVT) or lungs (pulmonary embolism or PE) from occurring again
Form: Oral tablet
Strengths: 10 mg, 15 mg, and 20 mg

Your dose of rivaroxaban depends on how well your kidneys are working.

Adult Dosage (ages 18 years and older)

Take 20 mg once per day with food

Child Dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years old.

Special Considerations

Kidney problems: Severe kidney problems: This drug shouldn’t be used.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Rivaroxaban comes with serious risks if you don’t take it as prescribed.

If You Don’t Take It at All

Your doctor will decide how long you should take rivaroxaban. Don’t stop taking it without talking to your doctor first. When you stop taking a blood thinner, you are likely to form a clot or have a stroke.

Be careful not to run out of rivaroxaban. Refill your prescription before you run out.

If You Skip or Miss Doses

If you stop taking rivaroxaban, miss doses, or don’t take it on schedule, it may increase your risk of blood clots or a stroke.

What to Do If You Miss a Dose

If you take rivaroxaban:

  • Two times per 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 its regularly scheduled time.
  • Once per day: Take it as soon as you remember on the same day. Take your next dose at its regularly scheduled time. Don’t take two doses at once to try to make up for the missed dose.

If You Take Too Much

If you take more than your prescribed dose of rivaroxaban, you have a greater risk of bleeding, which can be fatal. If you think you’ve taken too much, call your doctor or go to the emergency room right away.

How To Tell If the Drug Is Working

You can tell rivaroxaban is working if your symptoms from the blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism) go away or improve:

  • If you’re being treated for a blood clot in your leg, the swelling, pain, warmth, and redness will improve.
  • If you’re being treated for a blood clot in your lungs, your shortness of breath and chest pain when breathing will get better.

Rivaroxaban can be both a short-term and long-term drug treatment

Your doctor will decide how long you should take it.

ke the 15 mg and 20mg tablets with food

The 10mg tablet can be taken with or without food.

You may need to take this drug at dinner

If you have nonvalvular atrial fibrillation and take this drug to prevent stroke and blood clots, you need to take it in the evening with dinner.

You can crush the tablet

If you crush it, mix it with a small amount of applesauce. Eat the applesauce and then eat your meal right afterwards.

Store rivaroxaban at 77°F (25°C)

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Be sure that you have enough medication before you leave on your trip. It may be difficult to fill this prescription since not every pharmacy has it in stock.

Clinical Monitoring

During treatment with rivaroxaban, your doctor may check:

  • you for active bleeding. If you have signs of bleeding, your doctor may do some tests to see if you’re actively bleeding.
  • your kidney function. If your kidneys aren’t working properly, your body won’t be able to clear out the drug as well. This causes more of the drug to stay in your body, which may put you at risk for bleeding. Your doctor may decrease your dose of this drug or switch you to a different blood thinner.
  • your liver function. If you have liver problems, rivaroxaban won’t be processed by your body well. This causes levels of the drug to increase in your body, which may put you at risk for bleeding. Your doctor may switch you to a different blood thinner.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for rivaroxaban.

Are There Any Alternatives?

There are several drugs that work to treat or prevent blood clots. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on June 30, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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