Xarelto (rivaroxaban) is a prescription blood thinner used to prevent and treat blood clots. It can lower the risk of serious problems like stroke, deep vein thrombosis (DVT), or pulmonary embolism (PE). It's comes as a tablet or liquid and is taken by mouth. Your dose depends on why you're taking it, so it could be once or twice a day. The most common side effect is bleeding, which can sometimes be serious or life-threatening. Xarelto (rivaroxaban) is available as both a brand-name and a generic medication.
Adults:
Children:
Xarelto (rivaroxaban) is a direct-acting oral anticoagulant (DOAC) that works by blocking factor Xa, a protein your body uses to form clots. By stopping this protein, Xarelto (rivaroxaban) helps thin your blood and prevent clots from forming or getting bigger.
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Adults
Children
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Back pain
bleeding gums
bloody stools
bowel or bladder dysfunction
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
coughing up blood
difficulty with breathing or swallowing
dizziness
headache
increased menstrual flow or vaginal bleeding
leg weakness
nosebleeds
numbness
paralysis
prolonged bleeding from cuts
red or black, tarry stools
red or dark brown urine
vomiting of blood or material that looks like coffee grounds
Incidence not known
Blistering, peeling, or loosening of the skin
blurred vision
chills
clay-colored stools
dark urine
fast or irregular heartbeat
fever with or without chills
general feeling of tiredness or weakness
hoarseness
joint or muscle pain
loss of appetite
lower back or side pain
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
severe headache
sores, ulcers, or white spots in the mouth or on the lips
stomach pain or swelling
tightness in the chest
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
vomiting
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Xarelto (rivaroxaban) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Don't stop taking Xarelto (rivaroxaban) unless your prescriber tells you to. Stopping too soon can raise your risk of serious blood clots. If you need to stop for any reason other than bleeding or finishing treatment, your prescriber might have you start on another blood thinner to help keep you protected.
If you’re taking Xarelto (rivaroxaban) and need spinal or epidural anesthesia (numbing around your spine) or a spinal tap, you might have a higher risk of bleeding near your spine. This type of bleeding, called a spinal or epidural hematoma, is rare but can cause long-term or permanent paralysis. Your care team will explain how to safely stop Xarelto (rivaroxaban) before the procedure to help lower this risk. Call your prescriber right away if you notice back pain, weakness, numbness, difficulty walking, or a loss of bowel or bladder control.
Since Xarelto (rivaroxaban) is a blood thinner, it can raise your risk of bleeding, including serious and life-threatening bleeding. You might bruise more easily, and bleeding might take longer to stop. Your risk of bleeding is higher if you have certain other medical conditions or take other medications that cause bleeding. Get medical help right away if you or your child have bleeding that doesn't stop, blood in your urine or stool, coughing or vomiting blood, or feel dizzy or lightheaded.
There are medications, such as Andexxa (andexanet alfa), that can reverse the effects of Xarelto (rivaroxaban) in an emergency. But these reversal medications are given through a vein (intravenously, IV) and are usually only available in the hospital. It's very important that all healthcare professionals, including emergency responders, know you're taking Xarelto (rivaroxaban). Wearing a medical alert bracelet that lists this medication can help keep you safe.
Some medications can change how much Xarelto (rivaroxaban) is in your body. This can lead to more side effects or bleeding (like with ketoconazole, ritonavir), or make the medication not work as well (like with carbamazepine or rifampin). Be sure to tell your prescriber and pharmacist about all prescription, over-the-counter medications, and supplements you're currently taking or have recently stopped.
Xarelto (rivaroxaban) can cause uterine bleeding, which can be a problem if you're pregnant. Tell your care team right away if you’re pregnant or planning to become pregnant while taking this medication. You should only keep taking it if the benefits are greater than the risks. Let them know immediately if you have signs of bleeding, like feeling weak, having low blood pressure, or if there are any concerns about your baby.
Xarelto (rivaroxaban) isn't recommended for people with prosthetic heart valves. Studies have shown that people with a certain type of heart valve procedure had a higher risk of serious side effects, like bleeding and death, when taking this medication. If you have an artificial heart valve, talk to your care team about safer treatment options.
Xarelto (rivaroxaban) isn't recommended for people with triple-positive antiphospholipid syndrome (APS) because it's been linked to a higher chance of blood clots coming back. If you have APS, your prescriber will likely recommend a different medication to help reduce your risk for clots.
Adults:
The dose and how long you take Xarelto (rivaroxaban) will depend on why you're taking it. Your dose might be lower if you have kidney problems.
Children:
The dose is based on your child's weight. Depending on their weight and the condition being treated, the medication is taken by mouth 1 to 3 times a day.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Xarelto (rivaroxaban) will not be safe for you to take.