Rivaroxaban

What is rivaroxaban?

Rivaroxaban, sometimes known by its brand name Xarelto, is a blood thinner (anticoagulant). It makes it harder for your blood to clot thereby reducing the risk of serious conditions like stroke, heart attack, or pulmonary embolism[1].  

What is rivaroxaban used to treat?

Doctors prescribe rivaroxaban to[1]: 

• Prevent blood clots after certain surgeries 

• Treat DVT (deep vein thrombosis) and PE (pulmonary embolism) 

• Prevent DVT/PE from recurring 

• Lower stroke risk in people with non-valvular atrial fibrillation 

• Reduce risk of heart attack, stroke, or death in people with coronary or peripheral artery disease 

How does rivaroxaban work?

Rivaroxaban blocks Factor Xa, a key part of the clotting process. By stopping this step, it prevents new clots from forming and helps break down existing clots[1].  

Who can take rivaroxaban?

Most adults can take rivaroxaban. But it's not suitable for people who[1]: 

• Are allergic to rivaroxaban or any of the ingredients listed as part of the medication 

• Have active bleeding or condition that has a high risk of bleeding  

• Have severe liver problems 

• Are pregnant or breastfeeding (unless advised by a specialist) 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of rivaroxaban?

Rivaroxaban comes as 2.5mg, 5mg, 10mg and 20mg tablets, as well as granules for children and young people under 18. Your dose depends on your condition but may be altered depending on your renal function and weight[1]: 

• Atrial fibrillation: 20mg a day, but could be lower if you have kidney disease or are at a higher risk of bleeding 

• DVT/PE treatment: 15mg twice daily for 3 weeks, then 20mg once daily 

• Post-surgery prevention: 10mg once daily 

• Post-heart attack or for unstable angina: 2.5mg twice a day 

Always follow your doctor’s instructions when taking medication. 

How do you take rivaroxaban?

Rivaroxaban should be taken at the same time each day[1]: 

• 15mg or 20mg doses: take with food 

• 2.5 or 10mg dose: with or without food, however taking with food may help with stomach upset 

• Swallow tablets whole with water 

Can you stop taking rivaroxaban?

No – don’t stop suddenly unless your doctor tells you to. Stopping can increase your risk of stroke or blood clots[1]. 

What do you do if you take too much rivaroxaban?

Overdose increases bleeding risk. Contact your doctor or call 111, if you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance. . Take your medication packaging with you[1]. 

What do you do if you forget a dose of rivaroxaban?

It depends on whether you’re taking it once or twice daily[1]: 

• Once daily: Take it as soon as you remember. If it’s the next day, skip the missed dose and carry on taking once a day as normal. 

• Twice daily: Take the missed dose as soon as possible, then continue as usual. Don’t double up. 

Medicines to avoid with rivaroxaban

Some medications can interact dangerously with rivaroxaban. Avoid or use caution with[1]: 

• NSAIDs (e.g., ibuprofen) 

• Other anticoagulants (e.g., warfarin, heparin) 

• Antiplatelets (e.g., aspirin, clopidogrel) 

• Certain antifungals and antibiotics 

• Herbal supplements like St john’s wort 

Please note this is not a complete list, always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2].  

What are the side effects of rivaroxaban?

Common side effects include[1]: 

• Bleeding more easily (e.g., nosebleeds, bruising) 

• Headaches 

• Dizziness 

• Indigestion or stomach pain 

Serious side effects (seek urgent help)[1]: 

• Heavy/prolonged bleeding 

• Blood in urine or stools 

• Coughing up blood 

• Sudden vision changes or severe headache 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include:

• Difficulty breathing

• Tightness in throat and chest

• Swelling of the tongue or throat

• Feeling faint or dizzy

• Blue/grey skin or lips

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about rivaroxaban

Is rivaroxaban safer than warfarin? 
It has fewer food and medication interactions and doesn’t need as regular INR tests, but both have bleeding risks[1]. 

Can I drink alcohol on rivaroxaban? 
Yes, in moderation. Heavy drinking increases bleeding risk[1]. 

Do I need blood tests like with warfarin? 
Rivaroxaban doesn’t usually require INR monitoring; however, you may require regular renal, liver and blood tests to ensure treatment is safe and dose is correct[1] 

For the official NHS guide for rivaroxaban, visit their website.