Rivaroxaban - Common brands: Xarelto

What rivaroxaban is for

Rivaroxaban is a medicine called an anticoagulant. It helps to prevent blood clots forming. Some people call these medicines blood thinners.

It's used to prevent conditions such as:

• a blood clot in a vein (usually in the leg) called deep vein thrombosis (DVT)
• a blood clot in your lungs called a pulmonary embolism

You may also be offered it to prevent blood clots and strokes if you have:

• a heart rhythm problem called atrial fibrillation
• recently had knee replacement or hip replacement surgery
• coronary heart disease, peripheral arterial disease, or you are recovering from a heart attack

How to take rivaroxaban

Rivaroxaban comes as a tablet that you swallow with water.

How much you need to take and for how long depends on why you’re taking it.

You'll usually need to take it once or twice a day, at the same time every day. You take it with food.

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

You must use contraception while taking rivaroxaban if there's a chance you could get pregnant. This is because it could cause bleeding that could harm you and your baby.

Speak to a doctor or pharmacist for advice about what type of contraception may be the most effective for you.

If you miss a dose of rivaroxaban

If you forget to take a dose of rivaroxaban, take it as soon as you remember, unless it’s nearly time for your next dose.

If it’s nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much rivaroxaban

Taking an extra dose of rivaroxaban can be dangerous.

Side effects of rivaroxaban

Like all medicines, rivaroxaban can cause side effects.

One of the most common side effects of taking rivaroxaban is bleeding more than usual. This might include:

• bleeding for longer than usual if you cut yourself
• nosebleeds
• bleeding from your gums when you brush your teeth
• bruises that come up more easily and take longer to fade than usual
• periods that are heavier and last longer than usual

Other side effects may include:

• a problem with your blood cells (anaemia), which can make you feel tired and your skin paler than usual
• itchy skin
• arm and leg pain
• swelling in your arms and legs
• constipation or diarrhoea
• stomach pain or indigestion
• feeling sick (nausea) or being sick (vomiting)
• low blood pressure, which can make you feel faint and dizzy when you stand up

If you feel faint or dizzy after taking rivaroxaban, do not drive, ride a bike or use machinery until you no longer have these symptoms.

Serious side effects

Rivaroxaban can sometimes cause serious side effects.

A common serious side effect is heavy bleeding or internal bleeding. This might include:

• bleeding in your pee and poo
• blood in your vomit or coughing up blood
• bleeding in your eyes
• bleeding from the surgical wound after you've had surgery
• bleeding in the brain – you might have a sudden bad headache with confusion, sensitivity to light, slurred speech, difficulty moving your arms or legs, or feeling or being sick

Other serious side effects are rare. They may include an allergic reaction (anaphylaxis), which causes symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing.

Who can and cannot take rivaroxaban

Most adults and children can take rivaroxaban.

Rivaroxaban is not suitable for some people. For example, it may not be suitable if:

• you've had an allergic reaction or serious side effect from rivaroxaban or another anticoagulant
• you have injuries that are bleeding a lot
• you have a condition that increases your risk of serious bleeding, such as a stomach ulcer or bowel ulcer, or certain types of cancer
• you've recently had a bleed in your brain, or brain surgery
• you have high blood pressure
• you have liver disease
• you have antiphospholipid syndrome (a blood clotting disorder)
• you're pregnant or breastfeeding

Breastfeeding and rivaroxaban

Tell your doctor if you're breastfeeding. Rivaroxaban should not be used while breastfeeding as it passes into breastmilk.

Pregnancy and rivaroxaban

Tell your doctor if you’re pregnant or planning to get pregnant.

Rivaroxaban is not used during pregnancy as it may not be safe for the baby.

Taking rivaroxaban with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with rivaroxaban.

This includes:

• other medicines that prevent blood clots (anticoagulants), such as warfarin
• some medicines for fungal infections (antifungal medicines)
• some medicines for an irregular heartbeat
• some types of antidepressant medicines, such as SSRIs
• some painkillers or anti-inflammatories (NSAIDs)
• medicines to treat epilepsy
• some antibiotics
• the herbal remedy for low mood, St John's wort

Before taking rivaroxaban, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with rivaroxaban

You can eat and drink as normal while taking rivaroxaban.