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Varoxia
Varoxia (generic name: rivaroxaban) is an anticoagulant (blood thinner) that is used to prevent and treat blood clots. It is primarily prescribed to reduce the risk of stroke and blood clots in individuals with non-valvular atrial fibrillation, to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), and to prevent blood clots in individuals undergoing surgery, such as hip or knee replacement. Varoxia belongs to a class of medications known as factor Xa inhibitors, which work by reducing the formation of blood clots.
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Frequently Asked Questions
How long does it take for Varoxia to start working?
Varoxia begins to work within hours after taking the first dose, but the exact time to full effect depends on the condition being treated.
Can I stop taking Varoxia once my symptoms improve?
No, do not stop taking Varoxia without consulting your healthcare provider, as stopping suddenly can increase the risk of stroke or blood clots.
What should I do if I miss a dose of Varoxia?
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at once.
Can I drink alcohol while taking Varoxia?
Moderate alcohol use may be acceptable, but excessive alcohol can increase the risk of bleeding. Discuss your alcohol consumption with your healthcare provider.
Is Varoxia safe during pregnancy?
Varoxia is not recommended during pregnancy, as it may harm the fetus. Consult your healthcare provider if you are pregnant or planning to become pregnant while on Varoxia.
Comprehensive Drug Guide
How Does Varoxia Work?
Varoxia works by inhibiting Factor Xa, a key enzyme in the blood clotting process. By blocking Factor Xa, Varoxia reduces the formation of fibrin, a protein that is essential for blood clots. This prevents existing clots from getting bigger and helps reduce the formation of new clots, decreasing the risk of stroke, DVT, or PE.
Common Dosages
- 2.5 mg, 10 mg, 15 mg, and 20 mg oral tablets.
Typical Dosing
- For non-valvular atrial fibrillation: The typical dose is 20 mg once daily with the evening meal.
- For treatment of DVT or PE: The usual dose is 15 mg twice daily for the first 21 days, followed by 20 mg once daily.
- For prevention of DVT after hip or knee replacement surgery: The typical dose is 10 mg once daily for 12 days (knee replacement) or 35 days (hip replacement).
- For CAD or PAD: The dose is typically 2.5 mg twice daily along with aspirin.
Typical Dosing
FDA Approved Indications
- Prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation.
- Treatment and prevention of DVT and PE.
- Prevention of DVT in patients undergoing hip or knee replacement surgery.
- Reduction of cardiovascular events in patients with coronary artery disease (CAD) or peripheral artery disease (PAD).
Who Shouldn't Take Varoxia?
- Active bleeding or high risk of bleeding.
- Severe kidney impairment.
- Known hypersensitivity to rivaroxaban or any component of the formulation.
- Pregnancy (Varoxia may cause harm to the fetus).
Advice From The Pharmacist
- Take Varoxia with food (for the 15 mg and 20 mg doses), as this increases its absorption. For the lower doses, it can be taken with or without food.
- If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose. Do not double up doses.
- Avoid activities that may increase your risk of bleeding or injury while taking Varoxia, as it thins the blood.
- Inform your healthcare provider of any dental or surgical procedures you have planned, as you may need to stop taking Varoxia temporarily.
- Store Varoxia in a cool, dry place away from moisture and heat.
Side Effects of Varoxia
Common Side Effects
- Increased risk of bleeding (e.g., nosebleeds, bruising easily).
- Fatigue
- Dizziness
- Headache
Uncommon/Severe Side Effects
- Severe bleeding (e.g., prolonged bleeding, blood in urine or stool, coughing up blood).
- Liver problems (yellowing of the skin or eyes, dark urine).
- Spinal or epidural hematoma (increased risk of bleeding in the spine during certain procedures, leading to paralysis).
Risks and Warnings of Varoxia
- Bleeding Risk: Varoxia increases the risk of serious bleeding, including life-threatening and fatal bleeding events. If you experience any unusual bleeding, seek medical attention immediately.
- Spinal/Epidural Hematoma: Patients receiving spinal or epidural anesthesia or undergoing spinal puncture while taking Varoxia are at increased risk of developing a spinal hematoma, which can lead to paralysis. Notify your healthcare provider if you are having these procedures.
- Kidney Function: In patients with reduced kidney function, Varoxia may increase the risk of bleeding, and dose adjustments may be necessary.
- Discontinuation Risk: Stopping Varoxia suddenly can increase the risk of blood clots or stroke. Consult your healthcare provider before discontinuing use.
Interactions with Varoxia
Common Drug Interactions
- Antiplatelet drugs (e.g., aspirin, clopidogrel): These medications increase the risk of bleeding when taken with Varoxia.
- NSAIDs (e.g., ibuprofen, naproxen): These can increase the risk of gastrointestinal bleeding when taken with Varoxia.
- Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): These medications may increase the levels of Varoxia in the body, increasing the risk of side effects.
- Warfarin or other anticoagulants: Combining with Varoxia can increase the risk of bleeding.
Alternatives to Varoxia
- Apixaban (Eliquis): Another Factor Xa inhibitor used for similar indications.
- Dabigatran (Pradaxa): A direct thrombin inhibitor used for preventing and treating blood clots.
- Warfarin: A vitamin K antagonist used for preventing blood clots, though it requires regular blood monitoring.
