Xarelto (rivaroxaban) Uses, Side Effects, Efficacy, and Interactions | Omudhome Ogbru, PharmD | RxEconsult

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Xarelto (rivaroxaban) Uses, Side Effects, Efficacy, and Interactions Category: Anticoagulation (clot prevention) by - November 7, 2011 | Views: 13493 | Likes: 0 | Comment: 0  

Xarelto | rivaroxaban

Medication Class: Factor Xa inhibitor
Manufacturer: Janssen Pharmaceuticals
Approval date: November, 2011

What is Xarelto and how does it work

Xarelto is an oral anticoagulant that prevents blood clots by blocking the action of factor Xa. Factor Xa is a blood protein that is involved in the formation of blood clots.

What does Xarelto treat

  • Prevention of stroke and blood clots in patients with nonvalvular atrial fibrillation (a type of abnormal heart rate and rhythm).
  • Prevention of blood clots in leg veins (deep vein thrombosis, DVT) and in the lungs (pulmonary embolism, PE) in patients undergoing hip or knee replacement surgery.
  • Treatment of DVT or PE

How effective is Xarelto

  • Xarelto 20 or 15 mg daily was similar to warfarin in preventing stroke or blood clots in patients with nonvalvular atrial fibrillation.
  • Xarelto 10 mg daily was better than enoxaparin 40 mg daily in reducing the risk of deep vein thrombosis after knee replacement surgery. Blood clots occurred in 9.7% of patients treated with Xarelto compared to 18.8% of patients treated with enoxaparin.

What are interesting facts about Xarelto

  • It is the first oral factor Xa inhibitor.
  • It does not require monitoring with blood clotting tests.
  • It is not derived from heparin.
  • It should not be administered to patients with liver disease or very poor kidney function.

How is Xarelto dosed and administered

Xarelto is an oral medication supplied as 10, 15, and 20 mg tablets.

Nonvalvular Atrial fibrillation: 15 or 20 mg daily with the evening meal. Dosing depends on kidney function.

Prevention of deep vein thrombosis: 10 mg daily for 12 days after knee replacement surgery or 35 days after hip replacement surgery.

Treatment of DVT or PE: 15 mg twice daily for 21 days then 20 mg once daily for the remaining treatment period.

What are the side effects of Xarelto

Common: Bleeding, rash, blisters, fainting, muscle spasm, bruising.

Serious: Major bleeding, bleeding in the lungs, bleeding in the brain, severe allergic reactions.

Xarelto drug interactions

These drugs reduce the break down of Xarelto in the liver and therefore may increase the effect of Xarelto leading to increased risk of bleeding.

  • Ketoconazole
  • Norvir (ritonavir)
  • Kaletra (lopinavir/ritonavir)
  • Crixivan (indinavir)
  • Biaxin (clarithromycin)
  • Erythromycin
  • Diflucan (fluconazole)
  • Sporanox (itraconzole)

These drugs increase the breakdown of Xarelto in the liver and may reduce its effect.

  • Rifampin
  • St. John’s wort
  • Tegretol (carbamezepine)
  • Dilantin (phenytoin)

Combining Xarelto with other drugs that cause bleeding may increase the risk of bleeding. Examples include:

  • aspirin or aspirin containing products,
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • Coumadin, Jantoven (warfarin)
  • any medicine that contains heparin
  • Plavix (clopidogrel)
  • Effient (prasugrel)
  • Brilinta (ticagrelor)

What is the cost of Xarelto

It cost about $27 per tablet for the 10 mg tablets.

How to obtain prescription assistance for Xarelto

For prescription assistance for Xarelto visit acess2wellness.

References: Xarelto FDA Prescribing Information and Medication Guide

This medication summary is for information only and is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider.

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