rivaroxaban at a glance
Medicine class
Direct oral anticoagulant and direct factor Xa inhibitor.
Main safety concern
Bleeding, which may be visible or internal.
Food and formulation
Food requirements differ between formulations; follow the label and pack leaflet.
What is rivaroxaban used for?
Licensed uses vary by product and formulation. They include:
Preventing stroke and systemic embolism in adults with non-valvular atrial fibrillation and relevant risk factors.
Treating deep-vein thrombosis and pulmonary embolism, and preventing these clots from returning.
Preventing venous thromboembolism after elective hip or knee replacement surgery with suitable formulations.
Treating venous thromboembolism and preventing recurrence in children and adolescents who meet formulation-specific age, weight and prior-treatment criteria.
How does rivaroxaban work?
Rivaroxaban directly blocks activated factor X (factor Xa), a key step in blood clotting. This reduces thrombin generation and clot development without directly inhibiting thrombin or platelet function.
rivaroxaban preparations and strengths
Capsule
Route: Oral
Strengths: 10 mg, 15 mg, 20 mg
Oral suspension
Route: Oral
Strengths: 1 mg/mL, 5 mg/mL
How to take rivaroxaban
Take rivaroxaban exactly as shown on the dispensing label. Instructions differ by formulation.
The selected film-coated tablet should be swallowed with liquid and taken with food. When necessary, it may be crushed and mixed with water or apple purée, followed immediately by food. Do not split it to obtain a partial tablet.
The selected hard capsule may be taken with or without food. It may be opened and mixed with water or apple purée immediately before administration.
Shake the oral-suspension bottle for five seconds before use and measure it with the supplied oral syringe. Food requirements depend on the prescribed amount.
Suitable formulations may be administered through a correctly positioned gastric tube. Administration beyond the stomach can reduce absorption.
Carry the anticoagulant alert card and show it before medical, dental or surgical procedures.
rivaroxaban side effects
Common or expected effects
- Bleeding more easily, including nosebleeds, bleeding gums, easy bruising or heavier menstrual bleeding.
- Anaemia, which may cause tiredness, pallor, dizziness or breathlessness.
- Nausea, vomiting, abdominal discomfort, indigestion, constipation or diarrhoea.
- Headache, dizziness, itching, rash or limb swelling.
Get urgent medical advice
- Heavy, persistent or unexplained bleeding; blood in urine or stools; vomiting or coughing up blood.
- A sudden severe headache, confusion, speech disturbance, weakness or other neurological symptoms suggesting intracranial bleeding.
- Severe allergic reaction with breathing difficulty or swelling of the face, mouth, tongue or throat.
- A spreading, blistering or otherwise severe rash, particularly with mouth or eye involvement.
rivaroxaban in pregnancy
The selected product information contraindicates rivaroxaban during pregnancy because of potential reproductive toxicity, placental transfer and bleeding risk. Anyone who is pregnant, planning pregnancy or becomes pregnant while taking it should contact their prescriber or specialist promptly.
rivaroxaban while breastfeeding
The selected product information contraindicates rivaroxaban during breastfeeding, and NHS patient information advises against its use. Specialist UK pharmacy guidance notes that it may sometimes be considered when clinically indicated for someone breastfeeding a full-term, healthy infant, with infant monitoring. This requires an individual specialist decision and does not change the product licence.
rivaroxaban interactions
Ask a pharmacist or prescriber before starting, stopping or changing medicines, including non-prescription and herbal products.
Other anticoagulants
Combining anticoagulants can substantially increase bleeding risk and is generally contraindicated except during specified switching or catheter-management circumstances.
NSAIDs and antiplatelets, including ibuprofen and aspirin
These can increase bleeding risk; use only when a clinician has assessed the combination.
Systemic azole antifungals and HIV protease inhibitors
Strong CYP3A4 and P-glycoprotein inhibition can raise rivaroxaban exposure and bleeding risk; relevant combinations are not recommended.
Common questions about rivaroxaban
Answers are fully visible for fast scanning and source review.
Is rivaroxaban a blood thinner?
Yes. It is an anticoagulant that reduces the blood's ability to form harmful clots; it does not literally make blood thinner.
Are rivaroxaban and Xarelto the same medicine?
Xarelto is a brand name for rivaroxaban. Other UK products also contain rivaroxaban, but administration instructions and excipients can differ.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.