How Long Does Xarelto Stay in Your System? Plus 6 More Xarelto FAQs

Xarelto (rivaroxaban) is a blood thinner that treats and prevents unwanted blood clots. But how does Xarelto work, and how long does it stay in your system after you stop taking it?

Below, we’ll answer seven common questions about Xarelto. Keep in mind that you can always reach out to your pharmacist or healthcare provider if you have questions that aren’t covered here.

1. How does Xarelto work?

Xarelto belongs to a class of medications known as direct-acting oral anticoagulants (DOACs). It works by blocking a protein in your blood (factor Xa) that’s involved in forming blood clots. Blocking factor Xa helps prevent blood clots from forming.

Promotion disclosure

Xarelto (Rivaroxaban)

Avg retail price

$615.14(Save 83.37%)

GoodRx discount

$102.27

Compare all prices

Unlike warfarin (Coumadin, Jantoven), Xarelto doesn’t require frequent blood tests or careful meal planning. This makes Xarelto a more convenient treatment option for many people.

Good to know: When we talk about unwanted blood clots, we’re not talking about a clot that forms to stop bleeding, such as when you cut your finger. Unwanted blood clots form when there isn’t any bleeding. If this happens in a vein, it’s called a deep vein thrombosis (DVT). If it happens in the lungs, it’s called a pulmonary embolism (PE).

2. How long does it take Xarelto to work?

Xarelto starts to work within a few hours of your first dose. It takes 2 to 4 hours to reach its highest levels in your blood after you take it. Unlike some other blood thinners, it doesn’t take several days for Xarelto to build up in your body. 

Xarelto is taken once a day. It’s best to take the 15 mg and 20 mg tablets with food. This helps your body absorb the medication so it can start working as expected. But you can take lower doses of Xarelto with or without food. The body absorbs lower doses well either way.

3. How long does Xarelto stay in your system?

For most people, it takes 1 to 2 days after your last dose to clear Xarelto from your body. That’s why it’s best to stop taking Xarelto at least 24 hours before a surgery or procedure that’s likely to cause bleeding.

Xarelto may stay in your system longer if you have kidney or liver issues. Xarelto is cleared from the body by the liver and kidneys. So, any health conditions that slow down kidney or liver function can also slow down how fast Xarelto leaves the body.

4. How long do you have to take Xarelto?

How long you take Xarelto depends on why you’re taking it. In some cases, Xarelto may only be taken for a short time. In others, Xarelto may be a lifetime medication.

Below is a chart with the recommended treatment length of Xarelto by condition. Keep in mind that the amount of time you take Xarelto may differ. Your healthcare provider will decide what’s best for your specific needs, so be sure to follow their directions. 

Keep in mind: You shouldn’t stop taking Xarelto on your own. If you stop taking it too soon, your risk of blood clots goes up. This could lead to a life-threatening health event, such as a stroke. Your healthcare provider will let you know if and when it’s OK for you to stop taking Xarelto.

5. Can you switch from warfarin to Xarelto?

Sometimes. Warfarin may be a better treatment option for certain people, such as those with a mechanical heart valve. But if your healthcare provider OKs it, you can switch from warfarin to Xarelto.

To make the switch, your provider will have you stop taking warfarin. Then, once your INR is less than 3 (less than 2.5 for children), you’ll start taking Xarelto. INR stands for international normalized ratio. It’s a blood test that measures how long it takes your blood to clot.

Other anticoagulants to Xarelto 

You may need to switch from another blood thinner (other than warfarin) to Xarelto. To make this switch, you’ll stop your current blood thinner. Then you’ll start taking Xarelto in place of it when your next dose was originally due.

Xarelto to other anticoagulants 

Switching from Xarelto to another blood thinner can also happen. If you’re making this switch, stop Xarelto and start the new anticoagulant when the next dose of Xarelto would have been due. 

If you’re switching from Xarelto to warfarin, the process is a bit more complex. You may need to take more than one blood thinner while you’re waiting for warfarin to start working. Your provider will give you specific instructions to follow in this case.

6. Is Xarelto safe to take?

Yes, Xarelto is considered a safe medication for most people. But, like all medications, there are still side effects and risks to consider when you’re taking it.

Xarelto’s main risk is that it raises the chance of bleeding while you’re taking it. But in studies, Xarelto had a lower risk of serious and fatal bleeding than warfarin. 

Your bleeding risk may be higher with Xarelto if you:

• Have liver or kidney disease

• Take other medications that make bleeding more likely, such as aspirin or certain antidepressants

• Are age 65 or older

Let your provider know if you notice signs of mild bleeding while taking Xarelto. These include nose bleeds, light bruising, or bleeding from the gums while brushing your teeth. 

You should seek medical attention right away if you notice signs of severe bleeding, such as: 

• Bleeding that doesn’t stop

• Bruising that worsens or doesn’t go away

• Blood in your urine

• Blood in your stool (can be bright red or black, tarry stool)

• Coughing up blood

• Vomiting blood (may look like coffee grounds)

7. How can you save on Xarelto?

There are ways to save on Xarelto, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Xarelto’s patient assistance program, which offers the medication at no cost.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 for Xarelto using a savings card from the manufacturer.

Why trust our experts?

Written by:

Justin DeFlorian, PharmD, BCPS

Justin DeFlorian, PharmD, BCPS, is a board-certified clinical pharmacist. He received his Doctor of Pharmacy degree from the University of Wisconsin-Madison.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Our editorial standards

Meet our experts