Xarelto (Rivaroxaban) Dosing

January 24, 2025
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Cardiovascular
Featured Post

Xarelto (rivaroxaban) is a widely prescribed blood thinner that helps prevent dangerous blood clots. The mode of action is through direct factor inhibition, which is used for preventing stroke, treating deep vein thrombosis (DVT), and other critical indications. With tailored dosing regimens and diverse applications, Xarelto meets the needs of millions of patients worldwide.

Quick Facts About Xarelto

  • Xarelto is available in 2.5mg, 10mg, 15mg, and 20mg tablets
  • Typically taken once or twice daily
  • 15mg and 20mg doses should be taken with food for optimal absorption. 10mg doses can be taken without food according to the manufacturer’s guide.
  • Dosing varies by medical condition
  • After starting, it requires no routine coagulation monitoring

Xarelto Dosing by Medical Condition

Non-Valvular Atrial Fibrillation (NVAF)

Standard Dosing:

  • 20mg once daily with evening meal
  • Must be taken consistently at the same time

Kidney Function Considerations:

  • Normal to mildly impaired (CrCl >50 mL/min): 20mg daily
  • Moderately to severely impaired (CrCl 15-50 mL/min): 15mg daily
  • Severe impairment (CrCl <15 mL/min): Not recommended

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

Initial Treatment:

  • First 21 days: 15mg twice daily
  • After 21 days: 20mg once daily

Long-term Prevention:

  • 10mg or 20mg once daily after completing at least 6 months of treatment following an individual risk assessment from a licensed healthcare provider.

Special Dosing Considerations

Renal Impairment

Renal Impairment: Decreased kidney function that may affect how medications are processed in the body. CrCl (Creatinine Clearance): A measure of kidney function

Dosing Adjustments:

  • CrCl >50 mL/min: No adjustment needed
  • CrCl 15-50 mL/min: Reduced dosing required
  • CrCl <15 mL/min: Not recommended

Hepatic Impairment

  • Xarelto is a contradiction in patients with excessive bleeding risks (coagulopathy) and compromised liver function (Child-Pugh B or C cirrhosis patients).

Important Safety Considerations

Perioperative Management On Xarelto - When to Stop Before Procedures

  • Xarelto 10/15/20 mg: stop at least 24 hours before surgery
  • Xarelto 2.5 mg: stop at least 12 hours before surgery
  • May need longer for high-risk procedures
  • Consult healthcare provider for specific timing

When to Contact Your Doctor

Seek immediate medical attention if you experience:

  • Unusual bleeding or bruising
  • Persistent headaches
  • Dizziness or weakness
  • Red or brown urine
  • Black or bloody stools

Important! This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

References

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for medical diagnosis and treatment. The information provided is current as of January 2025, but medical knowledge and availability status may change rapidly. Verify any critical information with your healthcare provider.