Xarelto 20mg Tablets 14’s

Indications

Xarelto is taken for both treatment and prevention of blood clots

1. Prevention of Venous Thromboembolism (VTE):
   Adults undergoing elective hip or knee replacement surgery.
2. Treatment & Prevention of Recurrence:
   Deep vein thrombosis (DVT) and pulmonary embolism (PE).

Dosage

• VTE Prevention (Post-Surgery):
  1. 10 mg once daily, starting 6–10 hours post-surgery.
  2. Duration: 5 weeks (hip surgery) or 2 weeks (knee surgery).
• DVT/PE Treatment:
  1. Initial: 15 mg twice daily for 3 weeks.
  2. Maintenance: 20 mg once daily.
  3. Extended Prevention: 10 mg once daily (or 20 mg if high recurrence risk).
• Renal Impairment:
  CrCl 15–29 mL/min: 15 mg once daily after an initial 3-week 15 mg twice-daily regimen.
  Avoid if CrCl < 15 mL/min.

The dosage provided here does not negate your doctor’s prescribed dosage.

Side Effects

• Common : Bleeding (epistaxis, GI hemorrhage), anemia, dizziness, elevated liver enzymes.
• Serious (Rare):
  1. Major bleeding (cerebral, gastrointestinal)
  2. Hypersensitivity reactions (anaphylaxis, Stevens-Johnson syndrome)
  3. Compartment syndrome, acute renal failure.

Precautions

• Monitor for signs of bleeding (e.g., unexplained hemoglobin drop).
• Avoid it in active bleeding, recent CNS trauma, or high-bleeding-risk lesions.
• Use with caution in renal & liver impairment.
• In surgical procedures, discontinue 24 hours pre-surgery if possible.

It is contraindicated in pregnant/breastfeeding mothers

Xarelto contains lactose; avoid in galactose intolerance.

Interactions

Avoid concomitant use with:

1. Strong CYP3A4/P-gp inhibitors, e.g., ketoconazole and ritonavir, as they increase rivaroxaban levels.
2. Strong CYP3A4 inducers, e.g., rifampicin, reduce rivaroxaban efficacy.

Use with caution with:

• NSAIDs, antiplatelets, SSRIs/SNRIs increase bleeding risk.

Monitor INR 24 hours after the last rivaroxaban dose before initiating warfarin