Rivaroxaban

May 22, 2020

Medicine

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Rivaroxaban is a prescription used for:

• The treatment of blood clots in people with deep vein thrombosis or pulmonary embolism
• Preventing blood clots that could cause a heart attack in people who have suffered an acute coronary syndrome
• Preventing blood clots in people with coronary arteries disease or peripheral disease
• Preventing blood clots that could cause stroke

This medication is also prescribed for use in people with atrial fibrillation who also have these risk factors for having a stroke;

• Age over 75 years
• Heart failure
• History of stroke
• Diabetes
• High blood pressure

The Food and Drug Administration (FDA) has already approved this medication. Rivaroxaban is a type of medicine called anticoagulant that blocks certain clotting proteins in your blood. This drug comes as tablets with the dosage strengths of 2.5 mg, 10 mg, 15 mg, and 20 mg. 

Blood Clots

A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a needed process that can prevent you from losing excessive blood in certain instances. When a clot forms inside one of your veins, it won’t always dissolve on its own. This can be a very dangerous and even life-threatening situation. An immobile blood clot generally won’t harm you, but there’s a chance that it could move and become dangerous. If a blood clot breaks free and travels through your veins to your heart and lungs, it can get stuck and prevent blood flow. This is a medical emergency. Certain risk factors increase your chances of having a blood clot. Common factors that might put you at risk for a blood clot may include:

• Age (over 65 years old)
• Pregnancy
• Obesity
• Cancer
• Smoking
• Bed rest
• Certain birth control pills 
• Lengthy travel 

Symptoms of a blood clot include:

• Throbbing or cramping pain
• Swelling, redness, and warmth in a leg or arm
• Sudden breathlessness
• Sharp chest pain that may be worse when you breathe in 
• Cough or coughing up blood
• Blood clots can be life-threatening if not treated quickly.

Blood Clots being Dangerous 

These usually form to stop the bleeding. However, it can sometimes form inside the blood vessels. This is unsafe because the clot can block the blood vessel. It may as well travel in the bloodstream. Eventually, it might get lodged in a blood vessel that supplies a vital organ such as the heart, brain, or lungs. Some conditions can increase the risk of blood clots forming inside the blood vessels because they disturb your normal blood flow. For instance, if you have fatty deposits on the walls of your blood vessels which is a type of fast irregular heartbeat, this can lead to platelets clumping together and starting off the clotting process. 

How does the medicine work?

Blood clotting begins when blood cells called platelets clump together and produce chemicals that activate clotting factors in the blood. The activated clotting factors cause a protein called fibrinogen to be converted into another called fibrin. Fibrin binds the platelets together which forms a blood clot. Rivaroxaban works by binding to clotting factor Xa and ultimately decreases the formation of fibrin and makes the blood less able to clot. 

How To Use

The dose prescribed and how often you need to take it depends on the reason for taking the medicine. It’s important to follow the instructions given by your doctor. The medicine can be taken with or without a meal.

For the treatment of blood clots in people with deep vein thrombosis or pulmonary embolism

The usual dose is one 15 mg tablet taken twice a day for three weeks. After this your doctor may ask you to take one 20 mg tablet once a day as directed by your doctor. This depends on the cause of the initial blood clot and how likely you are to get another.

For preventing blood clots in people with coronary arteries disease or peripheral disease

The usual dose is one 2.5 mg tablet taken twice a day on a long-term basis. Your doctor will also ask you to take low-dose aspirin or aspirin plus clopidogrel along with this medicine.

For preventing blood clots that could cause stroke

The usual dose is one 20 mg tablet taken once a day on a long-term basis.

Side Effects

Common side effects:

• Bleeding complications such as major bleeding events
• Itching
• Fainting
• Muscle pain
• Pain in your arms or legs
• Muscle spasms

Call your doctor right away if you have these side effects:

• Easy bruising or bleeding (nosebleeds, heavy menstrual bleeding, or bleeding gums)
• Any bleeding that will not stop
• Pain, new drainage, swelling, or excessive bleeding from a wound
• Headaches
• Dizziness
• Weakness
• Urine that looks pink, red, or brown
• Bloody or tarry stools
• Coughing up blood or vomit that looks like coffee grounds
• Symptoms of a spinal blood clot (numbness or muscle weakness in your lower body, back pain, or loss of bladder/bowel control)

Warnings and Precautions

• Don’t drink a lot of alcohol all in one go because this increases the risk of bleeding.
• It’s important to tell your doctor what medicines you are already taking. Here includes those bought without a prescription and herbal medicines, before you start taking Rivaroxaban. Similarly, check with your doctor before taking any new medicines once you’ve started Rivaroxaban. It is to make sure that the combination is safe. 
• Don’t take over-the-counter anti-inflammatories, painkillers, or cold and flu remedies that contain aspirin, naproxen, or ibuprofen while you’re taking this drug. These medicines should only be used on the advice of a doctor because they can increase the risk of bleeding.
• This medicine may not be recommended for use if you currently have severe bleeding, liver problems, an artificial heart valve, or have recently had surgery on your eyes, spine, or brain. 
• For pregnant, you need to use an effective method of contraception to prevent pregnancy while having this medication. It could be harmful to a developing baby. 
• If you need treatment with Rivaroxaban, you should not breastfeed. It is because we do not know if the medicine passes into breast milk. Consult your doctor first.