Xarelto Tablet 20mg

About Xarelto Tablet 20mg

Xarelto Tablet 20mg Uses

• Prevention of stroke and systemic embolism in patients with non valvular atrial fibrillation
• Continued treatment of deep vein thrombosis (DVT) after the initial higher dose phase
• Continued treatment of pulmonary embolism (PE) after the initial higher dose phase
• Reduction of the risk of recurrent DVT and PE following initial anticoagulant treatment
• Prevention of venous thromboembolism in select patients with acute medical illness during and after hospitalization

Xarelto Tablet 20mg Benefits

• Single fixed daily dose without routine blood coagulation monitoring
• Reduces stroke risk in atrial fibrillation as effectively as older injectable and oral anticoagulants
• No dietary vitamin K restrictions unlike warfarin
• Lowers long term risk of clot recurrence after DVT or PE
• Convenient oral tablet instead of daily injections for extended anticoagulant therapy

What Experts Say

Physicians prescribe Xarelto Tablet 20mg because rivaroxaban directly blocks factor Xa in the coagulation cascade, giving predictable anticoagulation without the frequent blood tests older anticoagulants require. This lowers stroke risk in atrial fibrillation and treats clots in the veins and lungs, without dietary vitamin K restrictions.

Doctors favor rivaroxaban for its fixed once daily dosing, though the 20mg strength must be taken with the evening meal for full absorption. Kidney function is checked before starting therapy and periodically after, since the drug is partly cleared by the kidneys and the dose is lowered in moderate renal impairment.

Experts warn against stopping Xarelto Tablet 20mg abruptly, since early discontinuation sharply raises stroke and clotting risk in atrial fibrillation patients. Before surgery, physicians usually pause the medicine for a set number of days beforehand instead of letting the patient stop it on their own. Any dose change should be guided by the treating doctor.

Drug Class

• Direct oral anticoagulant (DOAC)
• Factor Xa inhibitor

Xarelto Tablet 20mg formula

• Rivaroxaban

Available forms

• Tablet

How to use Xarelto Tablet 20mg?

• Take Xarelto Tablet 20mg once daily with the evening meal for proper absorption
• Swallow the tablet whole with water, do not crush or chew
• If unable to swallow whole, the tablet may be crushed and mixed with applesauce or water immediately before use, only on a doctor's advice
• Take at the same time every day to maintain steady anticoagulant effect
• Do not stop taking without consulting the prescribing doctor, even before minor procedures
• If a dose is missed, take it as soon as remembered the same day, then continue the normal schedule the next day

Drug Interactions

• Other anticoagulants: Combining rivaroxaban with warfarin, heparin, low molecular weight heparin or other blood thinners significantly raises bleeding risk and is generally avoided except during a supervised switch
• Antiplatelet drugs: Aspirin, clopidogrel and similar antiplatelet agents increase bleeding risk when combined with rivaroxaban, though this combination is sometimes used short term under close medical supervision
• NSAIDs: Regular use of ibuprofen, diclofenac or other NSAIDs with rivaroxaban raises the risk of gastrointestinal bleeding
• Strong CYP3A4 and P-glycoprotein inhibitors: Ketoconazole, itraconazole, ritonavir and similar strong dual inhibitors raise rivaroxaban blood levels and bleeding risk, and combined use is generally avoided
• Strong CYP3A4 and P-glycoprotein inducers: Rifampin, carbamazepine, phenytoin and St John's Wort can lower rivaroxaban levels and reduce its anticlotting effect, raising clot risk
• SSRIs and SNRIs: Antidepressants such as fluoxetine or venlafaxine may add to bleeding risk when combined with rivaroxaban

Risks and warnings

• Bleeding risk: Rivaroxaban increases the risk of serious and sometimes fatal bleeding, including gastrointestinal and intracranial bleeding, so any unusual bruising, blood in urine or stool, or prolonged bleeding needs urgent medical attention
• Spinal or epidural hematoma: Patients receiving spinal or epidural anesthesia or a spinal puncture while on rivaroxaban face a risk of spinal or epidural blood clots that can cause long term or permanent paralysis, so this must always be flagged to the anesthesia team beforehand
• Premature discontinuation: Stopping Xarelto Tablet 20mg early without switching to another anticoagulant increases the risk of stroke or clot formation, especially in atrial fibrillation
• Renal impairment: The dose is lowered in patients with moderate kidney impairment and the drug is generally avoided in patients with severe kidney disease, since rivaroxaban clearance depends partly on the kidneys
• Hepatic impairment: Not recommended in patients with liver disease associated with bleeding risk or significant coagulopathy
• Pregnancy and breastfeeding: Not recommended during pregnancy or while breastfeeding due to bleeding risk to the mother and fetus or infant
• Prosthetic heart valves: Not recommended in patients with mechanical heart valves, since safety and effectiveness have not been established in this group
• Antiphospholipid syndrome: Not recommended in patients with triple positive antiphospholipid syndrome due to a higher risk of recurrent clotting events compared with warfarin

Xarelto Tablet 20mg Side Effects

• Nosebleeds and bleeding gums
• Easy bruising or prolonged bleeding from minor cuts
• Heavier or prolonged menstrual bleeding
• Headache and dizziness
• Nausea, stomach pain or indigestion
• Skin rash or itching
• Back pain
• Blood in urine or stool, appearing pink, red or black
• Vomiting blood or material that looks like coffee grounds
• Coughing up blood
• Unusual weakness, numbness or severe headache that may signal internal or intracranial bleeding
• Signs of severe allergic reaction such as swelling of the face, lips or throat and difficulty breathing

Storage Conditions

• Store at room temperature, below 30°C
• Keep the tablets in their original blister pack until ready to use
• Protect from moisture and direct sunlight
• Keep out of reach of children
• Do not use beyond the expiry date printed on the pack