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Xarelto
Xarelto is an oral medication that belongs to a class of drugs known as anticoagulants or blood thinners. It is typically prescribed to prevent blood clots in individuals undergoing knee or hip replacement surgery and to treat and prevent the recurring of deep vein thrombosis (DVT) and pulmonary embolism (PE). It's also used to reduce the risk of stroke and blood clots in patients with atrial fibrillation. Common side effects include nosebleeds, heavy menstrual periods in women, mild bruising, or minor bleeding. However, it's believed that the benefits outweigh the potential complications.
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Frequently Asked Questions
Can I just stop taking Xarelto?
No, abrupt discontinuation of Xarelto may increase your risk of developing blood clots or having a stroke. Always consult your doctor before making changes to your medications.
What should I do if I miss a dose of Xarelto?
If you miss a dose of Xarelto, take it as soon as you remember that day. It's essential not to take two doses of Xarelto on the same day to make up for a missed dose.
Can I take Xarelto with over-the-counter painkillers like ibuprofen?
It's generally recommended to avoid taking over-the-counter NSAIDs like ibuprofen while you're on Xarelto because NSAIDs can increase your risk of bleeding.
Is it safe to drink alcohol while taking Xarelto?
It's generally best to avoid alcohol while taking Xarelto because alcohol can increase your risk of stomach or intestinal bleeding.
What should I do if I get injured or start bleeding while taking Xarelto?
If you're injured, particularly if you hit your head, or if you start bleeding while taking Xarelto, get medical help right away.
Comprehensive Drug Guide
How Does Xarelto Work?
Xarelto is a direct factor Xa inhibitor that prevents blood clots formation by selectively blocking the active site of factor Xa, an essential clotting factor, without requiring a co-factor (such as Antithrombin III) for activity.
What is Xarelto Used For?
FDA indications: Xarelto is primarily used to prevent stroke and systemic blood clots in adults with nonvalvular atrial fibrillation, or to treat and prevent deep vein thrombosis and pulmonary embolism.
Off-label uses: It has been used off-label for the prevention of blood clotting events in patients with certain types of heart disease.
Common Dosages
Tablets: 10mg, 15mg, 20mg
Typical Dosing
FDA Approved Indications
- For FDA-approved indications:
- Nonvalvular atrial fibrillation: 20mg once daily with the evening meal.
- Treatment of DVT and PE: 15mg taken twice a day for the first 21 days, then 20mg once daily.
- Prevention of DVT and PE after surgery: 10mg once daily, starting 6 to 10 hours after surgery.
Off-Label Uses
- For off-label uses:
- Post-surgical Prevention of DVT and PE: 10mg once daily for up to 35 days post-hip replacement surgery and up to 12 days post-knee replacement surgery.
Who Shouldn't Take Xarelto?
- Individuals with active or uncontrolled bleeding.
- People with severe kidney disease, especially those who also have corresponding conditions like heart disease or high blood pressure.
- Pregnant or breastfeeding moms, as it could affect the baby.
- Those under hypersensitivity or allergic to Xarelto.
- Patients with prosthetic heart valves.
Advice From The Pharmacist
- It's best to take Xarelto exactly how and when your doctor instructs.
- Avoid foods and drinks high in vitamin K. They can interfere with how Xarelto works.
- Don't suddenly stop taking Xarelto without talking to your doctor. This can increase the risk of blood clots.
- Call your doctor or get medical help right away if you have uncontrolled bleeding or if you fall and hit your head.
- Try to avoid activities that might lead to injury or bruising.
- If you're feeling dizzy or weaker than usual, avoid driving or using machinery.
- Always keep your appointments for regular blood tests and check-ups.
Side Effects of Xarelto
Common Side Effects
- You might have back pain.
- Feel dizzy or faint.
- You may notice blood in your urine.
- Your stools may look tarry or black, which is a sign of blood.
Uncommon/Severe Side Effects
- Rare side effects:
- You may vomit blood or vomit that looks like coffee grounds.
- Vision changes, speech problems, weakness on one side of your body.
- You might cough up blood or have pink or brown urine.
- Skin changes or rashes.
- Tightness in your chest.
- Yellowing skin and eyes, nausea, loss of appetite, dark urine (a sign of liver problems).
Risks and Warnings of Xarelto
- Like many other blood thinners, Xarelto carries a risk of internal bleeding, which can be severe or life-threatening. This risk is higher if you're over 65, have a history of stomach or intestinal bleeding, or if you're taking other medications that increase your risk of bleeding, such as aspirin or other NSAIDs.
Interactions with Xarelto
Common Drug Interactions
- Aspirin or other NSAIDs
- Other anticoagulants or blood thinners, like warfarin
- Medications that prevent or treat HIV infections, like ritonavir
- Certain antidepressants
- Certain antibiotics, like rifampin
Alternatives to Xarelto
- Apixaban
- Dabigatran
- Edoxaban
- Fondaparinux
- Warfarin
- Heparin
- Enoxaparin
