Rivaroxaban (Xarelto)

What is rivaroxaban?


Rivaroxaban (Xarelto®) is a drug that blocks the activity of the clotting factor called anti-Xa (anti-10-a). This causes the blood to take longer to form a clot. It can also prevent a clot from getting bigger. 


Why do I need a blood thinner?


Rivaroxaban is used to prevent stroke in patients with a heart rhythm called atrial fibrillation. Rivaroxaban can also be used to prevent or treat blood clots or for other conditionns specified by your doctor.


How should I take my rivaroxaban?


The usual dose of rivaroxaban is 20 mg once daily with your evening meal. Patients with decreased kidney function should take a lower dose of 15 mg once daily. Rivaroxaban should be taken with the evening meal. Food helps to make sure the drug is absorbed. You can crush this medication if you need to, but be sure to take it within four hours of crushing. Do not stop taking rivaroxaban unless instructed by your doctor.


What happens if I miss a dose?


If you miss a dose of rivaroxaban, take it as soon as you remember. Skip the dose if it is less than 12 hours until your next dose. Never double up on a dose to make up for a missed dose. Never change your dose or stop taking rivaroxaban unless your doctor has told you to do so. 


Will I need routine blood checks?


You will not need regular blood test to monitor rivaroxaban. You will need to have your kidney and blood counts monitored once to twice a year. Based on the results, your rivaroxaban dose may need to be changed or the drug may need to be stopped. 


How should I store rivaroxaban?


Rivaroxaban should be stored at room temperature. Avoid areas of excessive heat or moisture (not in a bathroom).


Possible side effects of rivaroxaban


These are less serious side effects. Call your doctor if these symptoms persist or worsen:

  • Rash
  • Mild back pain
  • Swelling of the extremities 

Minor bleeding may also occur while on rivaroxaban:

  • Bruising more than usual
  • Occasional nose bleeds
  • Prolonged menstrual bleeding (heavier than normal)
  • Prolonged bleeding after minor cuts 

If you have any question about whether your bleeding is a concern call your doctor. If you have a serious fall, hit your head, or if you are having any of these major bleeding side effects, call your doctor or go to the Emergency Room right away:

  • Any bleeding that lasts for more than 10 minutes
  • Red, black or tarry stool
  • Vomiting or coughing up blood
  • Red or dark brown urine
  • Severe headache or stomach ache 

Surgical, Dental or Other Medical Procedures


Tell all members of your health care team (surgeons, dentist, etc.) that you are taking a blood thinner. You may need to stop taking it before certain procedures. Be sure to tell your doctor or pharmacist if you were told to stop or hold your rivaroxaban. They may need to change you to another type of blood thinner before your procedure.


Interactions with Other Medicines


Ask your doctor or pharmacist before starting any other medicine, including over-the-counter medicines, vitamins and herbal products. The dose of rivaroxaban may need to be adjusted if an interacting medicine is started.




If you think you are or may become pregnant, tell your doctor right away. It is unknown how rivaroxaban will affect a fetus. If you become pregnant, your doctor will instruct you about your treatment options.