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Xarelto Starter Pack
Xarelto (generic name: rivaroxaban) is an oral anticoagulant used to prevent and treat blood clots. It is classified as a factor Xa inhibitor, which helps reduce the risk of blood clot formation. Xarelto is commonly prescribed to prevent deep vein thrombosis (DVT), pulmonary embolism (PE), and to reduce the risk of stroke in patients with atrial fibrillation (AFib). The Xarelto Starter Pack is designed to help patients transition through their initial treatment, with varying doses tailored to provide effective anticoagulation during the first few weeks of therapy.
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Frequently Asked Questions
How long do I need to take Xarelto?
The duration of treatment depends on the condition being treated. For DVT or PE, treatment typically lasts at least 3 to 6 months. For long-term prevention of strokes in AFib, Xarelto may be taken indefinitely.
Can I drink alcohol while taking Xarelto?
Alcohol can increase the risk of bleeding when combined with Xarelto. It is recommended to limit alcohol intake and discuss any alcohol consumption with your healthcare provider.
What should I do if I miss a dose of Xarelto?
If you are on the 15 mg twice-daily dose, take the missed dose as soon as you remember and ensure you take both doses on the same day. For the 20 mg once-daily dose, take it as soon as you remember, but do not take two doses at the same time.
Is Xarelto safe during pregnancy?
Xarelto is generally not recommended during pregnancy due to the potential risk of bleeding. If you are pregnant or planning to become pregnant, consult your healthcare provider for alternatives.
Can Xarelto be reversed if I experience severe bleeding?
There is a reversal agent called Andexxa (andexanet alfa) that can be used in cases of life-threatening or uncontrolled bleeding while on Xarelto. In emergencies, your healthcare provider may administer this antidote.
Comprehensive Drug Guide
How Does Xarelto Starter Pack Work?
Xarelto works by inhibiting factor Xa, an enzyme that plays a crucial role in the formation of blood clots. By blocking this enzyme, Xarelto disrupts the blood-clotting process, reducing the likelihood of clots forming in the veins, lungs, or heart. This helps prevent conditions like DVT, PE, and strokes caused by blood clots.
Common Dosages
- 15 mg tablets for the initial phase (twice daily)
- 20 mg tablets for the maintenance phase (once daily)
Typical Dosing
- For DVT and PE treatment, the typical dosing starts with 15 mg twice daily for the first 21 days, followed by 20 mg once daily for maintenance.
- For stroke prevention in atrial fibrillation, the typical dose is 20 mg once daily with the evening meal.
Typical Dosing
FDA Approved Indications
- Prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE) following surgery or in patients at risk
- Treatment of DVT and PE
- Reduction of stroke risk in patients with non-valvular atrial fibrillation (AFib)
- Prevention of blood clots in patients undergoing knee or hip replacement surgery
- Reducing the risk of cardiovascular events in patients with coronary artery disease (CAD) or peripheral artery disease (PAD)
Who Shouldn't Take Xarelto Starter Pack?
- Active pathological bleeding
- Known hypersensitivity to rivaroxaban or any other components of the formulation
- Severe renal impairment (depending on the indication)
- Prosthetic heart valves
Advice From The Pharmacist
- Take Xarelto with food to improve absorption, especially the 15 mg and 20 mg doses.
- Do not skip doses, as missing doses may increase the risk of developing blood clots.
- If you miss a dose of the 15 mg twice-daily regimen, take it as soon as you remember on the same day. If you miss a dose on the once-daily regimen, take it as soon as possible, but do not take two doses at once.
- Inform your healthcare provider of any planned surgeries or dental procedures, as Xarelto increases the risk of bleeding.
- Avoid using non-steroidal anti-inflammatory drugs (NSAIDs) or other blood-thinning medications unless prescribed by your doctor, as they may increase bleeding risk.
Side Effects of Xarelto Starter Pack
Common Side Effects
- Bleeding (nosebleeds, gum bleeding, or more serious internal bleeding)
- Bruising
- Dizziness
- Fatigue
- Stomach pain
Uncommon/Severe Side Effects
- Severe bleeding, such as gastrointestinal or intracranial bleeding
- Liver problems (elevated liver enzymes)
- Allergic reactions (rash, itching, swelling, or difficulty breathing)
Risks and Warnings of Xarelto Starter Pack
- Bleeding Risk: Xarelto increases the risk of bleeding, including serious or life-threatening internal bleeding. Patients should be monitored for signs of bleeding, such as unusual bruising or prolonged bleeding.
- Spinal/Epidural Hematomas: Patients receiving spinal or epidural anesthesia or undergoing a spinal puncture while on Xarelto are at risk for developing blood clots that may lead to long-term or permanent paralysis.
- Kidney and Liver Function: Patients with moderate-to-severe renal impairment or liver disease should use Xarelto with caution, as impaired function may lead to increased drug levels and a higher risk of bleeding.
Interactions with Xarelto Starter Pack
Common Drug Interactions
- Other anticoagulants or antiplatelet drugs: Taking Xarelto with medications like warfarin, aspirin, or clopidogrel increases the risk of bleeding.
- NSAIDs: Drugs like ibuprofen or naproxen can increase the risk of bleeding when taken with Xarelto.
- CYP3A4 inhibitors: Medications such as ketoconazole or ritonavir may increase Xarelto levels in the blood, raising the risk of bleeding.
Alternatives to Xarelto Starter Pack
- Eliquis (apixaban): Another factor Xa inhibitor used to prevent and treat blood clots.
- Pradaxa (dabigatran): A direct thrombin inhibitor that reduces the risk of stroke and blood clots.
- Coumadin (warfarin): A vitamin K antagonist used for long-term anticoagulation therapy.
- Lovenox (enoxaparin): A low-molecular-weight heparin used for short-term anticoagulation.
