What is Xarelto?
Xarelto, sold under the brand name Xarelto among others, is an anticoagulant (blood thinner) medication. It is used to prevent blood clots in the veins and arteries. Some common conditions where Xarelto is used include deep vein thrombosis (DVT), pulmonary embolism (PE), atrial fibrillation and prevention of systemic embolism after hip or knee replacement surgery.
How does it work?
Rivaroxaban works by blocking a clotting factor called factor Xa. Factor Xa is crucial for the blood clotting process as it helps in the formation of thrombin, another key clotting factor. By inhibiting factor Xa, Xarelto prevents the formation of thrombin and keeps the blood from clotting. This reduces the risk of harmful blood clots forming in the circulatory system that can cause conditions like DVT, PE or stroke.
Medical uses of Rivaroxaban
Deep vein thrombosis and pulmonary embolism: Xarelto is used to reduce the risk of DVT recurrence and treat DVT and PE. It is an alternative to warfarin for this purpose.
Atrial fibrillation: For patients with non-valvular atrial fibrillation, Xarelto helps reduce the risk of stroke and systemic embolism compared to warfarin.
Hip or knee replacement surgery: As post-operative prophylaxis, Xarelto is given to prevent vein blood clots after total hip or knee replacement surgeries.
How is Xarelto administered?
Xarelto comes as tablets that are taken orally, usually with food. The dosing depends on the medical condition being treated.
- For DVT/PE treatment, the typical dose is 15 mg twice daily for the first three weeks followed by 20 mg once daily.
- For atrial fibrillation, the usual dose is 20 mg once daily with the evening meal.
- For hip/knee replacement prophylaxis, the dose is 10 mg once daily, starting on the day after surgery until adequate mobility is regained.
Precautions and contraindications
As with any anticoagulant medication, Rivaroxaban carries risks of excessive bleeding if not used carefully. Some precautions to keep in mind include:
- Inform physicians about any history of bleeding disorders, ulcers or recent surgery/trauma.
- Avoid use in patients with active pathological bleeding.
- Use is not recommended in those with liver disease or severe kidney impairment.
- Xarelto interacts with several other drugs like HIV protease inhibitors, azole antifungals and some antibiotics.
- Caution is needed in elderly patients or those above body weight of 110 kg.
- Carry identification in case of any emergency medical treatment required.
Managing side effects of Rivaroxaban
Bleeding is the most common side effect seen with Xarelto. Some signs of potential bleeding include:
- Unusual bruising or small red or purple spots under the skin.
- Nosebleeds that will not stop.
- Bleeding gums or blood in urine or stools.
- Heavy menstrual bleeding or unusual vaginal bleeding.
- Coughing up or vomiting blood.
One needs immediate medical attention for any sign of internal bleeding like in lungs or brain. In case of minor bleeding, applying pressure can help stop it. Rare side effects include headache, dizziness, indigestion and rash.
Monitoring therapy and adherence
Unlike warfarin, Rivaroxaban does not require regular blood monitoring or dose adjustments. However, it is crucial to adhere to prescribed dosing schedule and inform doctors about any other medications or supplements being taken. Periodic check-ups are still needed to monitor its effectiveness and watch out for side effects or bleeding issues. Patients should also keep emergency contact numbers handy.
Xarelto serves as an effective oral alternative to warfarin for preventing blood clots in conditions like DVT/PE or atrial fibrillation. Careful consideration of risks and proper adherence to therapy are needed for its safe use as an anticoagulant medication.
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