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Xarelto falls within the category of medications known as factor Xa inhibitors. Its mechanism of action involves blocking the activity of a specific natural substance that aids in the formation of blood clots.
Xarelto is utilized to either treat or prevent blood clots, medically referred to as venous thromboembolism (VTE). These blood clots can manifest in either the legs (deep vein thrombosis, DVT) or the lungs (pulmonary embolism, PE).
Furthermore, this medication serves the purpose of preventing strokes or severe blood clots in adults with atrial fibrillation, a condition marked by irregular heartbeats, which increases the likelihood of clot formation within the body, potentially leading to strokes, unrelated to heart valve disease.
Additionally, Xarelto is prescribed to prevent DVT and PE in adults undergoing hip or knee replacement surgeries or individuals hospitalized due to severe illnesses and at risk of developing clots due to reduced mobility or other factors.
Moreover, it is combined with aspirin to reduce the risk of heart attack, stroke, or death in adults with coronary artery disease or peripheral arterial disease.
Xarelto is also employed for the treatment and prevention of recurrent DVT and PE in children and specific infants who have undergone at least 5 days of initial anticoagulation (blood thinner) treatment.
At times, Xarelto is used to decrease the risk of DVT or PE recurrence after receiving treatment for blood clots for a minimum of 6 months.
Furthermore, it is employed to prevent DVT and PE after heart surgery in children aged 2 years or older with congenital heart disease.
Warnings
It is crucial not to discontinue Xarelto without consulting your doctor, as abrupt cessation may heighten the risk of blood clots or stroke.
Certain medications may increase the risk of bleeding when used alongside Xarelto. Inform your doctor about all other medications you are currently using.
Contact your doctor immediately if you or your child experience signs of bleeding such as headaches, severe weakness or dizziness, bleeding gums, nosebleeds, heavy menstrual periods, abnormal vaginal bleeding, blood in urine, bloody or tarry stools, coughing up blood, vomit resembling coffee grounds, or persistent bleeding.
Xarelto can potentially cause a severe blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). Notify any healthcare provider treating you that you are taking Xarelto.
Avoid using Xarelto if you have an artificial heart valve.
Before taking this medication
Avoid using Xarelto if you are allergic to rivaroxaban or any ingredients in Xarelto tablets, or if you have active or uncontrolled bleeding.
Rivaroxaban might increase the propensity to bleed, even from minor injuries. Contact your doctor if you experience bleeding that does not cease.
Rivaroxaban can induce a serious blood clot if you undergo procedures such as spinal tap or receive spinal anesthesia (epidural). Such blood clots could lead to permanent or long-term paralysis.
To ensure the safety of Xarelto, inform your doctor if you have ever experienced:
- Problems with your spine or spinal surgery history;
- Difficult or repeated spinal taps;
- Insertion of a thin tube (catheter) in your back for administering specific medication;
- Bleeding disorders;
- An artificial heart valve;
- Antiphospholipid syndrome, an immune system disorder that increases the risk of blood clots;
- Usage of NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and other blood clot-preventing medications; or
- Liver or kidney disease.
Using Xarelto during pregnancy may lead to bleeding in the mother or unborn baby. Inform your doctor if you are pregnant or planning to conceive.
It may not be safe to breastfeed while using this medication. Seek your doctor’s guidance regarding associated risks.
How should I take Xarelto?
Adhere to your doctor’s instructions meticulously and take Xarelto precisely as prescribed. Follow all directions on your prescription label and read all accompanying medication guides or instruction sheets. Your doctor may occasionally modify your dosage.
Avoid altering your dose or discontinuing this medication without your doctor’s advice, as abrupt cessation may increase the risk of blood clots or stroke.
Notify any healthcare provider treating you that you are using Xarelto. If you require surgery or dental work, inform the surgeon or dentist in advance about your Xarelto usage. In case you need anesthesia for a medical procedure or surgery, you may need to temporarily discontinue Xarelto.
For certain conditions, Xarelto should be taken with food. Whether to consume the medicine with or without food may also depend on the tablet strength. Follow your doctor’s dosing instructions very carefully.
If you are unable to swallow a Xarelto tablet whole, crush it and mix the medicine with a small amount of applesauce. Consume the mixture immediately without chewing. If you are taking the 15 mg or 20 mg tablet, the dose should be immediately followed by food.
Follow your healthcare provider’s instructions regarding Xarelto administration via a feeding tube if necessary.
Doses are weight-based in children and adolescents. Your child’s dose may require adjustment if there are fluctuations in weight.
If your child is taking the tablet, ensure it is swallowed whole. Xarelto tablets should not be divided to administer a smaller dose. Discuss with your doctor the possibility of transitioning to the oral suspension (liquid).
If your child vomits within 30 minutes of consuming the oral suspension (liquid), administer a new full dose. However, if vomiting occurs more than 30 minutes after consumption, refrain from administering another dose. Administer the subsequent dose as scheduled.
Shake the oral suspension (liquid) and measure a dose with the provided measuring device (not a kitchen spoon).
Store Xarelto at room temperature, away from moisture and heat. Do not freeze the oral suspension (liquid).
What happens if I miss a dose?
If you take Xarelto once daily: Take the missed dose as soon as you remember, then resume your regular schedule. Avoid taking two doses on the same day.
If you take the 15-milligram tablet twice daily: Consume the missed dose on the same day you recall it. The missed morning dose can be taken with the evening dose. Subsequently, adhere to your regular dosing schedule.
If you consume the 2.5-milligram tablet twice daily: Skip the missed dose and proceed with your next dose as scheduled. Refrain from administering two doses simultaneously.
If your child takes Xarelto twice daily: Administer the missed morning dose as soon as you remember. The missed morning dose can be administered with the evening dose. If you miss an evening dose, skip the missed dose and resume the regular schedule.
If your child consumes Xarelto thrice daily: Skip the missed dose and administer the subsequent dose as scheduled. Avoid administering two doses concurrently.
Ensure you refill your prescription before depleting your medication supply entirely.
What happens if I overdose?
Seek immediate medical attention or contact the Poison Help line at 1-800-222-1222 in the event of an overdose.
Overdosing may lead to excessive bleeding.
What should I avoid while taking Xarelto?
Refrain from activities that may increase the risk of bleeding or injury. Exercise caution while shaving or brushing