Rivaroxaban

Generic name: rivaroxaban [ RIV-a-ROX-a-ban ]

Brand names: Xarelto, Xarelto Starter Pack

Dosage forms: Granule for reconstitution (1 mg/mL), Kit (15 mg-20 mg), Tablet (10 mg; 15 mg; 2.5 mg; 20 mg)

Drug class: Factor Xa inhibitors

Route of administration: Oral.

Dose: Atrial Fibrillation: Dose: 20 mg once daily with the evening meal. Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): The initial dose is 15 mg twice daily for the first 21 days. Maintenance dose: 20 mg once daily.

Mechanism of action: Rivaroxaban is a selective factor Xa inhibitor. By inhibiting factor Xa, it prevents the conversion of prothrombin to thrombin, thus reducing thrombin formation and thrombus development. This anticoagulant effect helps to prevent blood clots in conditions like atrial fibrillation, DVT, and PE.

Drug usage cases: Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Treatment of DVT and PE. Prevention of DVT and PE recurrence. Prophylaxis of DVT may lead to PE in patients undergoing knee or hip replacement surgery.

Drug contraindications: Active pathological bleeding. Severe hypersensitivity to rivaroxaban or any component of the formulation. Use in patients with significant liver disease or with conditions associated with a high risk of bleeding.

Side effects: Common: Bleeding, anemia, gastrointestinal complaints. Serious: Major bleeding, liver enzyme abnormalities, thrombocytopenia. Rare: Severe hypersensitivity reactions, Stevens-Johnson syndrome.

Warnings: Monitor for signs of bleeding, including unusual bruising or bleeding. Use with caution in patients with renal impairment or those taking other medications that affect hemostasis. Discontinuation increases the risk of thrombotic events; consider coverage with another anticoagulant if discontinuation is necessary.

Use during pregnancy or breastfeeding: Not recommended during pregnancy due to the risk of hemorrhage and other complications. It is unknown if rivaroxaban is excreted in breast milk; consult your doctor before breastfeeding.