Xarelto is a medicine from the group of anticoagulants that is used to prevent the formation of blood clots that can be caused by an irregular heart rhythm or after surgery that can lead to the production of these clumps of blood. Cases of deep vein thrombosis (DVT) can also contribute to the formation of blood pools, as well as a pulmonary embolus (PE). It can then be said that the anticoagulant action of Xarelto works by inhibiting the action of some coagulation proteins that are present in the blood.

What is Xarelto and what is it for?

Xarelto is a drug that is often better known by its generic name: Rivaroxaban. This active principle works by blocking the activity of some proteins and clotting substances in the blood of people who consume it. Therefore, it is often used to treat or prevent DVT blood clots that can occur after surgery; or DVT clots, which can cause clots in the lungs (PEs).

Here are the most common uses for Xarelto, however, this drug has other important uses as well.

Xarelto helps reduce the risk of DVT or PE

Most of the time, Xarelto or Rivaroxaban is used in patients to lower the risk of having a DVT or PE after they have been treated for clots for 6 months.

Xarelto is used for heart rhythm disorder

This drug is also often prescribed for patients with atrial fibrillation (heart rhythm disorder), which helps lower the risk of stroke caused by a blood clot.

Uses and indications of Xarelto

Before starting treatment with this medicine, it is important that you raise any questions about it with your doctor, who, according to his criteria, will be the one who indicates the dose and corresponding time. The drug has been designed to be ingested by mouth. In the event that you are taking it for the prevention of blood clots after a hip or knee replacement surgery, the dose will be one dose per day.

In the case of taking the medicine for the prevention of strokes and blood clots caused by an irregular rhythm of the heartbeat, it will be taken for once during the day, preferably with dinner. When it comes to treating blood clots, it begins by taking the first three weeks twice a day, then it will be only once a day. The purpose of taking the medicine is to prevent blood clots from forming again.

For no reason should you increase or decrease the dose indicated by the doctor. In the case of the 10 mg tablet, you can take it with or without food, on the contrary, the 15 mg tablet if they must be taken in combination with food. In case of not being able to swallow the whole pill, you could crush it and mix it, which must be ingested immediately and be prepared just at the moment that the pill corresponds.

For those patients who have a gastric or nasogastric tube, the healthcare professional will instruct you on how to mix and administer it correctly. The extent of treatment will depend on the improvement of the patient. Try to take it at the same time every day so you don’t miss the appropriate dose.

What does Rivaroxaban contain?

The main asset of Xarelto, as we already mentioned is Rivaroxaban, this in turn, contains the following components in its core:

  • Croscarmellose sodium
  • Microcrystalline
  • Hipromelosa
  • Lactose monohydrate
  • Magnesium stearate
  • Sodium lauryl sulfate
  • Red iron oxide in its coating (E172)
  • Macrogol
  • Hipromelosa
  • Titanium dioxide (E171)

Caution on the use of Xarelto

As it is an anticoagulant drug, it is important to take into account some precautions:

You cannot stop taking Rivaroxaban suddenly without first talking to your doctor. Stopping this medicine overnight may increase the risk of stroke or blood clot.

The effects of Rivaroxaban can make it easier for the patient to leak some blood. In the event that any of the following scenarios occurs, it is necessary to call the doctor as soon as possible:

  • Headache
  • Dizziness
  • Lack of strength
  • Swollen gums
  • Heavy menstrual periods
  • Nosebleed
  • Abnormal vaginal bleeding
  • Bloody stools
  • Blood in the urine
  • Coughing up blood or vomit that looks like coffee grounds

There are a large number of drugs that can increase the risk of bleeding when taken in combination with Rivaroxaban. Therefore, it is always very important to talk with the doctor about all the medicines that the person consumes, so that he can make a good diagnosis and avoid major inconveniences.

If the person has a lumbar puncture or if they receive epidural anesthesia, Rivaroxaban can cause a serious blood clot around the spine. It is necessary for a specialist to know the details of the situation.

What are the side effects of Xarelto?

As we mentioned earlier, Rivaroxaban is a drug that can make people bleed more easily, so there may be a number of related side effects, such as:

  • Easy bleeding (from the nose or gums)
  • Heavy menstrual bleeding
  • Bruises
  • Swelling, pain, or drainage from a wound or the area where a needle was injected into the skin
  • Headache, weakness, dizziness, feeling faint
  • Bleeding that won’t stop
  • Bloody or tarry stools
  • Brown vomit
  • Bloody urine (pink, red, or brown)

It is necessary to keep in mind that bleeding is the most common side effect when taking Xarelto. However, the intervention of a doctor is necessary, in case of symptoms of an allergic reaction such as:

  • Hives
  • Swelling of the face, lips, throat, or tongue
  • Difficulty breathing

It is also necessary to get an emergency medical consultation, in case of symptoms of a blood clot in the spine, whose signs are the following:

  • Numbness from muscle pain in the lower body
  • Back pain
  • Loss of bowel and bladder control

Here we have mentioned the most common and not so common side effects, but it is important to keep in mind that people’s bodies react differently, so it is possible that some effects may occur in some people and not in others. Regardless of this, it is always advisable to contact the doctor as soon as possible, in case any of these appear.

Interaction with other medications

As is usual with the consumption of any drug, it is not entirely safe to take several at the same time, because some tend to affect blood levels, causing adverse effects or reducing their effectiveness. Some of the drugs that could interact with this drug are vitamins or herbal products.

The important thing in everything is to inform the doctor or, failing that, the pharmacist, about everything you are taking, whether with a prescription or not. Under no circumstances do you start, stop or change the dosage without medical approval. Other medications that could interact with this drug are:

  • Certain antidepressants
  • Mifepristona.
  • Anti-fungal azoles.
  • Cobicistat
  • Anticonvulsants
  • Rifamycin
  • Conivaptán.
  • AIDS protease inhibitors
  • Aspirin in high doses.

Precautions when taking Xarelto

The first precaution you should take is to notify your doctor if you are allergic to this drug or any other. This drug may have some inactive ingredients that can cause allergic reactions or other difficulties. In addition, it is important to inform your doctor if you have ever suffered from bleeding problems, kidney or liver disease, blood disorders, inherited enzyme problems, stroke, injuries, recent falls or surgeries, or eye problems.

If you are going to undergo a medical or dental procedure, you must notify the specialist that you are under treatment with this drug. Drinking alcoholic beverages during treatment increases the risk of stomach bleeding. During drug administration, try to be careful when handling sharp or cutting objects, to avoid bruises, wounds or cuts that can cause bleeding.

It is advisable to avoid the practice of sports that involve contact, with the intention of avoiding blows to the head. In the case of women, it is vital to inform the doctor if you are pregnant, breastfeeding or planning to become pregnant.

When and how much Xarelto should be taken?

Generally the usual dose is one 10 mg tablet once during the day, preferably with water, or if you prefer it can be with food. It is recommended to start treatment by administering the first tablet between 6 and 10 hours after the operation.

Then you will take one tablet each day as your doctor tells you. Try to take it every day at the same time to avoid forgetting. In the event that the patient has had major hip surgery, they will take the medication for approximately 5 weeks. If the surgery was knee, the treatment will be for 2 weeks.

As with any other medication, the doctor’s instructions and the prescription label must be followed to the letter, carefully reading all medication guides and their instructions. It is possible that on some occasions doctors change the dose of consumption, something that must be respected to comply with the treatment as indicated.

How many times Rivaroxaban will be taken per day will depend on why the medicine is to be taken.

In certain conditions the medicine has to be taken with food orally through tablets. However, the condition of doing it or not with meals will always depend on the concentration of the tablet. So the doctor’s dosing instructions have to be followed.

In case you have problems swallowing the Rivaroxaban tablet, you should tell your doctor, since some medicines cannot be crushed with your teeth.

If surgery or dental procedures are required, the surgeon or dentist should know that the patient is taking Rivaroxaban. Since in case anesthesia is needed to carry out a medical procedure, the consumption of Rivaroxaban should be stopped for a certain time.

Under no circumstances, and we emphasize this, should the dose be changed, unless indicated by the doctor, since stopping Xarelto may increase the risks of a blood clot.

What to do if you miss a dose of Xarelto?

If the dose indicated by the doctor is 1 tablet of Xarelto a day, the dose must be taken at the moment of remembering it and then it must be continued with the normal schedule. But under no circumstances should two tablets be consumed at the same time.


Xarelto is a drug whose active ingredient is rivaroxaban, which acts as an oral anticoagulant, by blocking coagulation factor Xa, reducing the natural tendency of the blood to form clots. It is generally prescribed after certain surgeries. Its most common adverse effect is bleeding, but if the patient makes sure to follow the doctor’s instructions, they will not be a greater evil.

Samantha Robson
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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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