Xarelto

Xarelto (Rivaroxaban) is an anticoagulant factor Xa inhibitor which works by inhibiting the formation of blood clots. Indications include minimizing the risk of stroke in patients with nonvalvular atrial fibrillation and treating deep vein thrombosis (DVT) or pulmonary embolism (PE). In addition to this, it is also used to help prevent the recurrence of DVT and PE, or for DVT prophylaxis (prevention) in patients who have recently had orthopedic surgery (such as knee or hip replacement).

This medicine works by selectively inhibiting FXa, an enzyme that is vital for the coagulation process. Factor Xa normally cleaves prothrombin, which leads to the formation of thrombin, a protease in the coagulation cascade which is responsible for converting fibrinogen into the protein fibrin. Generally, fibrin molecules help to entangle blood platelets, which results in a blood clot. However, by disrupting the process in which fibrin is synthesized, this medicine is able to reduce the ability of the blood to form clots.

Certain types of surgery can increase the risk of abnormal blood clots forming in the blood vessels (DVT). This may lead to pulmonary embolism (a blood clot in the lungs), and it may also affect the flow of blood to the organs (referred to as a thromboemoblism). In cases like these, physicians may recommend the use of this medicine for thromboprophylaxis, so as to prevent this from occurring. Patients already affected by DVT may also be given this medicine to treat the blood clots.

Xarelto (Rivaroxaban) is available as 10mg, 15mg and 20mg strength tablets. The correct strength of tablet needed will depend on the condition being treated, and your physician will decide for you. The 10mg tablets are used to prevent DVT in patients who have had orthopedic surgery. Generally, the dosage is 10mg taken once per day. If the patient has had their hip replaced, the physician will require them to continue treatment for 35 days. However, following a knee replacement, it is likely that the patient will be ordered to keep taking it for a period of 12 days. The 10mg tablets can be administered either with or without food.

Adults who are undergoing treatment for DVT or PE may be directed by their physician to take 15mg, twice per day for a period of 21 days. Following this, the patient will be told to take 20mg once per day for the remainder of the treatment period. The 15mg and 20mg tablets must be taken with food. When used to lower the risk of stroke in patients with nonvalvular atrial fibrillation, the dosage will depend on the creatinine clearance. Patients with a creatinine clearance of CrCl 15 to 50ml per min may be instructed to take 15mg once per day alongside their evening meal. If the patient`s creatinine clearance is greater than 50ml per min, the physician will order the patient to take 20mg, administered once per day together with the evening meal.

Side effects may occur in patients who take Xarelto (Rivaroxaban) tablets. Ensure that you report all reactions in full detail to your physician. A list of some commonly reported side effects is provided here:

• Nausea
• Vertigo
• Pruritis
• Abdominal pain
• Digestive discomfort

Should you suffer from brown or abnormal discoloration of urine, abnormal visual disturbances, speech difficulties, fever, bleeding or any other severe adverse events which are not referenced here, ensure that you consult your physician immediately.

Xarelto (Rivaroxaban) affects the formation of blood clots and this could cause side effects related to bruising or bleeding. If you notice nosebleeds, blood in the urine, vomiting up blood, coughing blood, bleeding from the gums or any other signs of bleeding ensure that you consult your physician immediately.

If treatment with anticoagulant medicine is withdrawn prematurely, the risk of complications arising from this are increased, which may include thrombotic events. Discuss this with your physician before commencing treatment.

Patients who undergo epidural anesthesia or any other injections into the spine while taking this medicine are considered to be at a higher risk of suffering from a blood clot in the spine, which may result in permanent paralysis.