Rivaroxaban is a type of anticoagulant used to prevent or treat harmful blood clots.
The most common side-effects are bleeding (such as nosebleeds) and feeling sick (nausea).
|Type of medicine||An anticoagulant|
|Used for||To prevent or treat harmful blood clots|
|Also called (UK and USA)||Xarelto®|
Rivaroxaban works by preventing your blood from clotting as quickly or as effectively as normal. It does this by blocking a substance in your blood which is involved in the development of blood clots, called factor Xa.
Sometimes, harmful blood clots can form in the veins of your legs, lungs, brain or heart, and cause a blockage. This is more likely to happen if you are having certain types of surgery, or if you have a fast irregular heartbeat. For many years, a medicine called warfarin has been commonly used to treat blood clots like these and also to help protect against them. However, people who take warfarin need to have regular blood tests to measure how quickly their blood clots. This often means that the dose of warfarin can change quite frequently. Rivaroxaban works in a slightly different way to warfarin, so people who take rivaroxaban do not need to have regular blood tests.
Rivaroxaban is prescribed to treat blood clots causing deep vein thrombosis and pulmonary embolism. You may also be prescribed rivaroxaban to help protect against blood clots if you are having hip or knee surgery, or if you have a certain type of irregular fast heartbeat known as atrial fibrillation.
Before taking rivaroxaban
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rivaroxaban it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have had any surgery recently (other than hip or knee surgery).
- If you have an ulcer in your stomach or intestines, or if you have recently recovered from one.
- If you have high blood pressure (hypertension).
- If you have a prosthetic heart valve or you are due to have heart valve replacement surgery.
- If you have any medical problems that may increase your risk of bleeding.
- If you have a problem with the blood vessels in your eyes, known as vascular retinopathy.
- If you have any problems with the way your liver works, or with the way your kidneys work.
- If you have a long-term lung condition called bronchiectasis.
- If you have been told you have a condition called antiphospholipid syndrome.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take rivaroxaban
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about rivaroxaban and will provide you with a full list of the side-effects which you may experience from taking it.
- Take rivaroxaban exactly as your doctor tells you to. It is usual to take one dose each day if it is to prevent a blood clot. If you are being treated because you have a blood clot, you will be asked to take two doses each day to begin with. Then, after three weeks, your dose will be reduced to one dose each day.
- Your doctor or pharmacist will tell you which strength of tablet is right for you as there are several strengths of rivaroxaban available. This information will be printed on the label of the pack to remind you.
- If the strength of the tablets you have been prescribed is 10 mg or lower, you can take these tablets either before or after meals. If you have been given the higher 15 mg or 20 mg strength tablets, you should take these with or just after a meal. This is because more of the dose is absorbed from these higher-strength tablets when there is food present in your stomach.
- Try to take rivaroxaban at the same time(s) each day, as this will help you to remember to take it regularly. If you have difficulty swallowing tablets, you can crush the tablet and mix it with a little water or apple purée to help you.
- If you forget to take a dose, take it as soon as you remember. If when you remember, it is nearly time for your next dose then take your next dose when it is due but leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress.
- If you have had hip or knee surgery, you will be asked to continue taking rivaroxaban for a certain number of weeks. If you are taking it for other reasons, you will be asked to continue to take it over a longer period of time.
- If you take any medicines that you have bought without a prescription, check with a pharmacist that they are suitable to take with rivaroxaban. This is because some medicines, such as some painkillers, may interfere with it.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Can rivaroxaban cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with rivaroxaban. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common rivaroxaban side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Bleeding (such as nosebleeds)||If the bleeding continues or becomes troublesome, let your doctor know|
|Feeling sick (nausea), indigestion, stomach upset||If you are not already doing so, try taking your doses after a meal|
|Feeling dizzy, tired or faint||If this happens, do not drive and do not use tools or machines until you feel well again|
|Changes in some blood tests, high temperature (fever), swollen feet or ankles, itchy rash||If you are concerned about any of these, speak with your doctor|
Important: if you experience any unusual bleeding, speak with your doctor straightaway or go to your local accident and emergency department.
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store rivaroxaban
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Xarelto® 10 mg film-coated tablets; Bayer plc, The electronic Medicines Compendium. Dated June 2019.
Manufacturer's PIL, Xarelto® 15 mg and 20 mg film-coated tablets; Bayer plc, The electronic Medicines Compendium. Dated July 2019.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.