Rivaroxaban (Xarelto®)

What is Rivaroxaban?

Rivaroxaban is an oral anticoagulant. Anticoagulants are medicines that treat and prevent blood clots.


You are taking Rivaroxaban for:

  • Atrial fibrillation, to prevent stroke
  • Deep vein thrombosis (DVT)
  • Pulmonary embolism (PE)
  • Prevention of PE or DVT (after hip or knee surgery)


Your dose of Rivaroxaban is:

  • 20 mg once daily with food
  • 15 mg once daily with food
  • 15 mg twice daily for 3 weeks, then 20 mg once daily with food
  • 10 mg once daily


Practical tips for taking Rivaroxaban:

Rivaroxaban should be taken as your doctor or pharmacist has told you.
It is important to take Rivaroxaban with food. Food is necessary for you to absorb the full amount of Rivaroxaban.


What if you miss a dose?

It is important to take Rivaroxaban regularly and to ensure you fill your prescription on time. If you miss a dose:

  • If your dose is Rivaroxaban 15 mg twice daily, take your missed dose as soon as you remember. You may double a dose if you have missed one because it is important for you to have a total of 30 mg each day. Continue your regular dose twice daily the next day.
  • If your dose is Rivaroxaban 10 mg once daily, 15 mg once daily or 20 mg once daily, take the missed dose as soon as you remember on the same day. Do not double up on your dose. Continue your regular dosing the following day.


Does Rivaroxaban have side effects?

Most people do not experience side effects.

  • All anticoagulants increase the risk of bleeding. Bleeding can be minor or major:
  • Minor bleeding stops on its own and does not last long. Examples of minor bleeding include: nose bleeding, gum bleeding, bruising, etc.
  • Major bleeding (see below) is more serious, requires medical attention, and stopping the Rivaroxaban at least temporarily.


When should you contact your doctor or pharmacist urgently?

If you have any of the following symptoms of bleeding:

  • Becoming pale, very weak and tired, shortness of breath or chest pain
  • Black/tarry or bloody bowel movements
  • Bleeding from the rectum
  • Pink/red or dark colored urine
  • Excessive menstrual bleeding
  • Coughing or vomiting up blood
  • Any bleeding that won’t stop
  • Physical injury such as head injury, broken bones, car accidents, sports injuries


What should you discuss with your health care providers?

Be sure that your health care providers know you are taking Rivaroxaban if you need surgery, dental work, chiropractic manipulations, any invasive procedure, or will be exposed to any bleeding risk

  • If you are starting any new medicine including an over the counter medicine.
  • Playing contact sports or any activities that may put you at risk of injury or bleeding is not recommended, and should be discussed.


Does Rivaroxaban require any kind of monitoring?

  • No regular blood testing to check the level of Rivaroxaban is needed. Your doctor does need to check how well your kidneys are working by doing a blood test called “creatinine”. Your kidney function must be known before starting Rivaroxaban. It should also be checked at least once a year and more often if your kidneys are not working well.
  • Patients taking Rivaroxaban do require follow-up with their physician.
  • Carrying a wallet card or ID bracelet that states you are taking Rivaroxaban is a good idea. In case of emergency, this would be important for health care providers to know.


Take Away Message

Rivaroxaban reduces your risk of developing blood clots

  • Remember to take your Rivaroxaban with food to ensure your body is able to absorb it.
  • Remember to take Rivaroxaban on schedule and refill your prescription early.
  • Do not stop taking Rivaroxaban without talking to your doctor.
  • Missing doses will reduce the effectiveness of this medicine. Immediately report symptoms of blood clot, such as stroke or blood clots in the leg or arm (DVT) or lungs (PE) (refer to the Thrombosis Canada website), to an emergency room.
  • Immediately report any unusual or major bleeding.
  • Changes to your health and/or medicines may affect Rivaroxaban. Contact your doctor or pharmacist if these occur.
  • Having an ID bracelet and wallet card with your medical information is a good idea.



The above information was directly obtained from the Thrombosis Canada website (thrombosiscanada.ca).


Did you know?

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Did you know that certain oral anticoagulants (blood thinners) don’t require regular blood tests and can be taken instead of warfarin (Coumadin) in patients with:


-Deep Vein Thrombosis or Pulmonary Embolism

-Atrial Fibrillation in patients who never had a  heart valve replacement

Did you know that there is an information video playing in CETAC about warfarin (Coumadin) that can also be viewed on this website?

Did you know that our Anticoagulation and Thrombosis clinic is now called CETAC ? It stands for  “Centre of Excellence in Thrombosis and Anticoagulation.”

Did you know that CETAC is heavily involved in research to advance the care and lifestyle of our patients? You can look on this website to see what studies we are doing and if you are a potential participant.