If you’re at risk for having certain types of blood clots, your doctor might suggest Xarelto (rivaroxaban) as a treatment option.

Xarelto is a prescription medication that’s used for the following purposes in adults:

Xarelto is also used in children to:

This article describes the dosages of Xarelto, including its forms, strengths, and how to take the drug. To learn more about Xarelto, see this in-depth article.

Note: This article covers Xarelto’s typical dosages, which are provided by the drug’s manufacturer. But when using Xarelto, always take the dosage that your doctor prescribes.

Read on to learn more about the dosages of Xarelto that are typically prescribed.

What are Xarelto’s forms?

Xarelto comes as a tablet and a liquid suspension (mixture) that you swallow.

What should I know about Xarelto’s strengths (2.5 mg, 10 mg, 15 mg, 20 mg, 1 mg/mL)?

Xarelto tablets come in four strengths: 2.5 milligrams (mg), 10 mg, 15 mg, and 20 mg. The strength of Xarelto tablets you take will depend on the condition you’re trying to prevent or treat.

Xarelto suspension comes in a strength of 1 mg per milliliter (mL).

What are the typical dosages of Xarelto in adults?

Typically, your doctor will start you on a therapeutic dose of Xarelto. (“Therapeutic” refers to the amount of drug that’s needed to treat your condition.) Then they’ll monitor your condition over time to make sure the drug is working for you. Your doctor will ultimately prescribe the lowest dosage that provides the desired effect.

The normal dosage for Xarelto depends on the drug’s indication (the condition the drug is used to prevent or treat). The information below describes dosages that are commonly recommended for each use. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for treating DVT and PE

Xarelto can be used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is a blood clot in a deep vein, usually in the thigh or lower leg. PE is a blood clot in the lungs.

For this purpose, the usual dosage of Xarelto is 15 mg twice each day for 21 days. Then the dose is lowered to 20 mg once each day.

For treating DVT or PE, you may take Xarelto for 6 to 12 months.

Dosage for reducing the risk of getting another DVT or PE

If you’ve had a DVT or PE in the past, Xarelto can be used to help lower your risk of getting either again.

The typical dosage of Xarelto for this use is 10 mg once each day.

You would start Xarelto after at least 6 months of using an anticoagulant drug (blood thinner).

Dosage for preventing DVT and PE after hip or knee replacement

If you have a hip or knee replacement surgery, Xarelto can be used to prevent DVT or PE from happening afterward.

The usual dosage of Xarelto for this purpose is 10 mg once each day.

How long you’ll take Xarelto depends on the type of surgery you had. If you have knee replacement surgery, you’ll likely take the drug for 12 days afterward. Following a hip replacement, you’ll likely take it for 35 days.

Dosage for preventing VTE in people who are hospitalized for an illness

In people who are hospitalized for an illness, Xarelto can be used to prevent venous thromboembolism (VTE), a type of blood clot in a deep vein.

When used for this purpose, the typical dosage of Xarelto is 10 mg once each day. If you’re using Xarelto to prevent VTE during and after a hospital stay, you’ll likely take it for 31 to 39 days in total.

Dosage for reducing the risk of stroke and blood clots in people with AFib

If you have atrial fibrillation (AFib) that isn’t caused by a heart valve problem, Xarelto can help lower your risk of blood clots and stroke.

The usual dosage of Xarelto for this purpose is 20 mg once each day with your evening meal.

Dosage for reducing the risk of cardiovascular events in people with CAD or PAD

Xarelto can be used to help lower the risk of cardiovascular events (such as heart attack and stroke) in people with coronary artery disease (CAD) or peripheral artery disease (PAD).

For this purpose, the typical dosage of Xarelto is 2.5 mg twice each day.

Dosage before surgery

Taking Xarelto can increase your risk for bleeding. For this reason, you may need to temporarily stop taking Xarelto before a planned surgery.

Your doctor will likely recommend that you stop taking Xarelto at least 24 hours before surgery. But do not stop taking the drug without talking with your doctor first. They’ll tell you whether you should stop taking Xarelto and give you instructions for the safest way to do so.

Dosage for people with kidney problems

Before your doctor prescribes Xarelto, they’ll likely give you kidney function tests. This is to make sure that your kidneys are working properly.

If your kidneys aren’t working properly, your doctor may not prescribe Xarelto. Or they might prescribe a lower dosage for you. This depends on the condition that you’re taking Xarelto to prevent or treat.

If you have kidney problems and have questions about the dosage that’s right for you, talk with your doctor.

What’s the dosage of Xarelto for children?

In children, Xarelto’s dosage is determined by body weight in kilograms (kg).* Below are the recommended dosages for Xarelto’s uses in children.

* One kg equals about 2.2 pounds (lb).

Dosage for treating and preventing VTE in children

Xarelto can be used in children for venous thromboembolism (VTE) treatment and prevention. The table below describes the recommended dosages for this use.

Note: For this use, doctors may prescribe Xarelto tablets or suspension for children who weigh 30 kg or more. Otherwise, children are typically prescribed Xarelto suspension.

Body weightXarelto dosageTotal daily Xarelto dose
2.6 kg to 2.9 kg (about 5.7 lb to 6.4 lb)0.8 mg suspension, three times per day2.4 mg
3 kg to 3.9 kg (about 6.5 lb to 8.6 lb)0.9 mg suspension, three times per day2.7 mg
4 kg to 4.9 kg (about 8.8 lb to 10.8 lb)1.4 mg suspension, three times per day4.2 mg
5 kg to 6.9 kg (about 11 lb to 15.2 lb)1.6 mg suspension, three times per day4.8 mg
7 kg to 7.9 kg (about 15.4 lb to 17.4 lb)1.8 mg suspension, three times per day5.4 mg
8 kg to 8.9 kg (about 17.6 lb to 19.6 lb)2.4 mg suspension, three times per day7.2 mg
9 kg to 9.9 kg (about 19.8 lb to 21.8 lb)2.8 mg suspension, three times per day8.4 mg
10 kg to 11.9 kg (about 22 lb to 26 lb)3 mg suspension, three times per day9 mg
12 kg to 29.9 kg (about 26.4 lb to 65.9 lb)5 mg suspension, twice per day10 mg
30 kg to 49.9 kg (about 66 lb to 110 lb)15 mg once each day, as a tablet or suspension15 mg
50 kg or more (about 110.2 lb or more)20 mg once per day, as a tablet or suspension20 mg

Your child will typically take Xarelto for at least 1 to 3 months, and possibly up to 12 months, for VTE.

Dosage for preventing blood clots in children with congenital heart disease

Xarelto can be prescribed to help prevent blood clots in children ages 2 years and older who have had the Fontan procedure. (This is a type of open-heart surgery for congenital heart disease.) The table below describes the recommended dosages for this use.

Note: For this use, doctors may prescribe Xarelto tablets or suspension for children who weigh 50 kg or more. Otherwise, children are typically prescribed Xarelto suspension.

Child’s body weightXarelto dosageTotal Xarelto dose per day
7 kg to 7.9 kg (about 15.4 lb to 17.4 lb)1.1 mg suspension twice per day2.2 mg
8 kg to 9.9 kg (about 17.6 lb to 21.8 lb)1.6 mg suspension twice per day3.2 mg
10 kg to 11.9 kg (about 22 lb to 26.2 lb)1.7 mg suspension twice per day3.4 mg
12 kg to 19.9 kg (about 26.4 lb to 43.8 lb)2 mg suspension twice per day4 mg
20 kg to 29.9 kg (about 44 lb to 65.9 lb)2.5 mg suspension twice per day5 mg
30 kg to 49.9 kg (about 66 lb to 110 lb)7.5 mg suspension once per day7.5 mg
50 kg or more (about 110.2 lb or more)10 mg once per day, as a tablet or suspension10 mg

Is Xarelto used long term?

In certain situations, Xarelto is meant to be used as long-term treatment.

The reason you’re taking Xarelto will determine how long you’ll take the drug. Listed below are the usual lengths of treatment for short-term uses of Xarelto. However, be sure to take the drug for the amount of time that your doctor recommends.

Reason for taking XareltoLength of Xarelto treatment
to treat DVT or PEfor 6 to 12 months
to prevent DVT or PE after knee replacement surgeryfor 12 days after your surgery
to prevent DVT or PE after hip replacement surgeryfor 35 days after your surgery
to prevent VTE during and after hospitalization for an illnessfor 31 to 39 days after being admitted to the hospital
to treat or prevent VTE in childrenfor 1 to 12 months

Xarelto is meant to be used as a long-term treatment when prescribed to help lower the risk of blood clots, heart attack, and stroke. If you and your doctor determine that Xarelto is safe and effective for you, it’s likely that you’ll use it long term for these purposes.

Dosage adjustments

Your doctor may adjust your Xarelto dosage based on several factors, such as having kidney problems or a planned surgery. For more information, see “Dosage before surgery” and “Dosage for people with kidney problems” above.

In children, weight will be monitored in case dosage adjustments are needed.

Below are answers to some common questions about Xarelto.

Does my dosage affect the side effects I might have from Xarelto?

It’s possible.

Studies of Xarelto didn’t look at the differences in side effects between higher and lower dosages of the drug. For most people, the Xarelto dosages recommended by the drug’s manufacturer are the lowest ones that provide the desired effects.

Taking a lower dosage than you are prescribed might cause the drug to be less effective for you. On the other hand, taking a higher dosage of Xarelto than you are prescribed can raise your risk for side effects from the drug.

Always take the dosage that your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

If you’re concerned about your risk for side effects from Xarelto, talk with your doctor.

Is there a specific dosage of Xarelto for older adults?

No, there isn’t a specific dosage of Xarelto for older adults. The dosages for older adults are generally the same as those for younger adults.

However, older people may have certain health conditions that affect their dosage of Xarelto. For example, older people may have a higher risk for kidney problems that could lead to a dosage adjustment.

If you’re an older adult with questions about what dosage of Xarelto is right for you, talk with your doctor.

Should I take my Xarelto doses with food?

The strength of Xarelto you’re prescribed will determine whether you take the drug with food.

If you’re prescribed the 2.5-milligram (mg) or 10-mg Xarelto tablets, you’ll take your doses with or without food. If you’re prescribed the 15-mg or 20-mg Xarelto tablets, you’ll take each dose with food.

Children taking Xarelto for venous thromboembolism (VTE) should take their doses with food. Children who have had the Fontan procedure can take Xarelto with or without food.

The dosage of Xarelto you’re prescribed may depend on several factors. These include:

  • the type and severity of the condition you’re using Xarelto to treat
  • other conditions you may have (see “Dosage adjustments” under “What is Xarelto’s dosage?”)
  • body weight, in children

Xarelto comes as a tablet and a liquid suspension (mixture). Both forms are taken by mouth.* The suspension comes with oral syringes that are used to measure doses.

Your reason for taking Xarelto and the strength you’re prescribed will help determine how you take the drug.

You’ll likely take Xarelto either once or twice each day. Children might take Xarelto once, twice, or three times per day.

For most conditions treated with a once-daily dose of Xarelto, you can take your dose at any time of day. Try to take it at the same time each day to keep consistent levels of the drug in your body.

If you’re taking Xarelto because you have atrial fibrillation (AFib), you should take your once-daily dose with your evening meal.

For conditions that require taking Xarelto twice per day, you should take one dose in the morning and one in the evening. Generally, you’ll separate your morning and evening doses by about 12 hours. Try to take your doses at the same times each day. Children taking Xarelto three times per day should separate their doses by about 8 hours.

* Xarelto liquid suspension can also be given through a feeding tube, such as a nasogastric (NG) tube, if needed.

Taking Xarelto with food

If you’re taking the 2.5-mg or 10-mg Xarelto tablets, you can take your dose with or without food. But if you’re taking the 15-mg or 20-mg Xarelto tablets, you should take each dose with food.

Children taking Xarelto for venous thromboembolism (VTE) should take their doses with food. Children taking Xarelto after the Fontan procedure can take their doses with or without food, as recommended by their doctor. If you have questions about how to take Xarelto, talk with your doctor.

It’s important that you don’t miss a dose of Xarelto. Missed doses can increase your risk for blood clots. Xarelto has a boxed warning for this risk, which is a serious warning from the Food and Drug Administration (FDA). For more information, see “Boxed warnings” at the beginning of this article.

If you do miss a dose of Xarelto, your usual dosage determines what you should do. Below are recommendations for how to handle a missed dose of Xarelto based on your normal dosage:

  • If you normally take 2.5 milligrams (mg) of Xarelto twice each day, skip your missed dose. You can take your next dose at its usual time. Do not take any extra doses of Xarelto to make up for your missed dose.
  • If you normally take 15 mg of Xarelto twice each day, take your missed dose as soon as you remember. Then take your next dose at its usual time. If you miss a morning dose but don’t remember until it’s time for your evening dose, you can take two 15-mg tablets (a total of 30 mg) for your evening dose. Make sure your total daily dose does not exceed 30 mg.
  • If you normally take 10 mg, 15 mg, or 20 mg of Xarelto once per day, take your missed dose as soon as you remember. Then take your next dose at its usual time. Do not take an extra dose to make up for your missed dose.
  • In children:
    • If your child takes Xarelto once per day, they should take their missed dose right away, but only on that day. They should not take two doses in one day to make up for a missed dose.
    • If your child takes Xarelto twice per day and they miss a morning dose, they should take the dose right away. Two doses can be taken in the evening to make up for a missed morning dose. If your child misses an evening dose of Xarelto, they should only take the missed dose on that same evening.
    • If your child takes Xarelto three times per day, they should skip a missed dose and go back to their usual dosing schedule.

If you need help remembering to take your dose of Xarelto on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not take more Xarelto than your doctor prescribes. Taking more than this can lead to serious side effects.

Symptoms of overdose

Overdose can cause excessive bleeding. Symptoms of excessive bleeding can include:

What to do in case you take too much Xarelto

Call your doctor right away if you think you’ve taken too much Xarelto. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. However, if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Xarelto for you, they will prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Xarelto without your doctor’s approval. Take Xarelto exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions that you may want to ask your doctor:

  • Should my dosage of Xarelto change if I eat certain foods?
  • Do I have any health conditions that could affect my dosage of Xarelto?
  • Should my Xarelto dosage change if I have a planned surgery?
  • Will I need any blood tests to determine my dosage of Xarelto?

To learn more about Xarelto, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Q:

I have trouble swallowing Xarelto tablets whole. Can I crush them and mix them with food or a drink?

Anonymous

A:

If you’re an adult and you have trouble swallowing Xarelto tablets whole, you may crush Xarelto tablets. You’ll mix the crushed tablet into applesauce or water to make it easier to take.

For children who have trouble swallowing tablets, doctors may prescribe Xarelto liquid suspension (mixture). The suspension is easier to swallow. Xarelto tablets should not be split in half to make a smaller dose for children.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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 another 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.