Why Xarelto® Is Prescribed, Common Dosages, And Other Instructions For Patients
People with blood clotting disorders live under the daily threat of strokes, heart problems, and other potentially fatal conditions. Many patients opt to take daily doses of blood thinning medications (called anticoagulants) that prevent blood from clotting inside the body and traveling to the heart, brain, and lungs.
While some of these medications may be taken less often, they carry significant and irreversible risks, so patients must consider their options carefully before choosing which blood thinner to take. In this article, patients can learn more about Xarelto®, including which conditions are treated, what dosages are recommended, and how your health may be affected while on this medication.
What Is Xarelto?
Xarelto® (rivaroxaban) is an an anticoagulant. Along with fellow medications Arixtra® and Eliquis®, Xarelto is in a class of medications called factor Xa inhibitors, which decrease the clotting ability of the blood. In the early 1970s, researchers discovered that dog hookworms secreted naturally-occurring inhibitors of factor Xa in order to prevent blood from clotting. Many animals that feed off the blood of others (such as leeches and ticks) use these inhibitors as a way to keep blood flowing, leading scientists to develop medications with these properties to prevent harmful clots.
Xarelto is prescribed for patients with:
- Atrial fibrillation. Xarelto is prescribed to patients suffering from erratic heart rhythms called non-valvular atrial fibrillation to prevent strokes and blood clots. Dosage depends on a patient’s creatinine level, as patients with higher creatinine clearance (CrCl) may be able to tolerate higher doses of the drug. Patients with atrial fibrillation are generally only prescribed 15-20 mg daily with food.
- Deep vein thrombosis. Blood thinners are often prescribed to prevent deep vein thrombosis (DVT), a condition where large clots form in the blood vessels of the legs and then travel to the lungs. If the clot becomes lodged in the lung tissue, the patient may suffer a blockage known as pulmonary embolism. Patients suffering from acute DVT are typically prescribed 15 mg of Xarelto twice daily which may be decreased to 20 mg once daily.
- Pulmonary embolism. If a patient has already suffered pulmonary embolism, Xarelto may be used in the treatment of the condition. The recommended dosage for the condition is usually 15 mg twice daily with food for the first 21 days, reduced to 20 mg once daily with food to prevent recurrence.
- Post-surgical clotting problems. Patients who have undergone hip or knee replacement surgery are often at high risk of blood clots in the weeks following the procedure. Xarelto is often used to prevent pulmonary embolism as patients recover, especially during times when patients are unable to walk. In these cases, 10 mg of Xarelto is generally administered once daily, with the first dose given 6 to 10 hours after surgery. Treatment may continue anywhere between 12 and 35 days after surgery.
Blood Thinners Carry Both Clotting and Bleeding Risks
Patients who are taking blood thinners must be careful to maintain a steady dosage, since too much or too little of the drug can cause complications. In particular, doctors and patients have been warned about the risks of switching from the common blood thinner warfarin to Xarelto. When adjusting your medications, patients should always follow the directions of their doctors to avoid adverse bleeding or clotting injuries.
Xarelto may be effective at combating blood clots, but the medication has also been linked to a number of patient deaths due to uncontrolled bleeding. In order to reduce the risks of bleeding while taking Xarelto, patients are advised to take the medication at the same time each day, allowing the body to maintain a constant level of clotting inhibitor. As skipping doses or accidentally taking an extra dose can increase the dangers of side effects, patients should call their doctors if their medication regimen has changed even by one dose.