Rivaroxaban

What is Rivaroxaban

Rivaroxaban is an oral and selective factor Xa inhibitor anticoagulant indicated for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients undergoing knee or hip replacement surgery, for the treatment of DVT and PE, for the reduction in risk of recurrence of DVT and PE in patients at continued risk following an initial 6 months of therapy, for stroke and systemic embolism prophylaxis in patients with nonvalvular atrial fibrillation, and for venous thromboembolism prophylaxis in acutely ill medical patients at risk for thromboembolic complications and not at high risk of bleeding.

It is also approved, in combination with aspirin, to reduce the risk of major cardiovascular events (cardiovascular death, myocardial infarction, stroke) in patients with chronic coronary artery disease or peripheral artery disease.

Similar to apixaban and dabigatran, rivaroxaban has a rapid onset of effect and predictable anticoagulant effects; routine laboratory monitoring is not required.

A reversal agent, factor Xa, is available when reversal of anticoagulation is necessary due to life-threatening or uncontrolled bleeding.

Brand Name

Xarelto | Xarelto Starter Pack

Indications

1. atrial fibrillation
2. coronary artery disease
3. deep venous thrombosis (DVT)
4. deep venous thrombosis (DVT) prophylaxis
5. myocardial infarction prophylaxis
6. pulmonary embolism
7. pulmonary embolism prophylaxis
8. reduction of cardiovascular mortality
9. stroke prophylaxis

Side Effects

1. abdominal pain
2. agranulocytosis
3. anaphylactic shock
4. angioedema
5. anxiety
6. back pain
7. bleeding
8. cholestasis
9. depression
10. dizziness
11. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
12. dyspepsia
13. fatigue
14. GI bleeding
15. hematoma
16. hepatitis
17. insomnia
18. intracranial bleeding
19. jaundice
20. muscle cramps
21. ocular hemorrhage
22. pruritus
23. retroperitoneal bleeding
24. sinusitis
25. spinal hematoma
26. Stevens-Johnson syndrome
27. subdural hematoma
28. syncope
29. thrombocytopenia

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• abrupt discontinuation
• anticoagulant therapy
• antiphospholipid antibody syndrome
• bleeding
• breast-feeding
• coagulopathy
• epidural anesthesia
• geriatric
• hepatic disease
• labor
• lumbar puncture
• neoplastic disease
• obstetric delivery
• pregnancy
• prosthetic heart valves
• renal failure
• renal impairment
• reproductive risk
• spinal anesthesia
• surgery

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