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rivaroxaban - XARELTO®

Usual Dosing (Adults)

Indications:
XARELTO is a factor Xa inhibitor indicated:

  1. to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
  2. for the treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for the reduction in the risk of recurrence of DVT and of PE
  3. for the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery

DOSAGE AND ADMINISTRATION

  • Take 15 mg and 20 mg tablets with food; take 10 mg tablets with or without food
  • Nonvalvular Atrial Fibrillation:
    • For patients with CrCl >50 mL/min: 20 mg orally, once daily with the evening meal
    • For patients with CrCl 15 - 50 mL/min: 15 mg orally, once daily with the evening meal
  • Treatment of DVT, PE, and Reduction in the Risk of Recurrence of DVT and of PE: 15 mg orally twice daily with food for the first 21 days for the initial treatment of acute DVT or PE. After the initial treatment period, 20 mg orally once daily with food for the remaining treatment and the long-term reduction in the risk of recurrence of DVT and of PE.
  • Prophylaxis of DVT Following Hip or Knee Replacement Surgery: 10 mg orally, once daily with or without food

DOSAGE FORMS AND STRENGTHS
Tablets: 10 mg, 15 mg, and 20 mg

Renal Dosing

dialysis Use in Patients with Renal Impairment:

Nonvalvular Atrial Fibrillation
Avoid the use of XARELTO in patients with CrCl <15 mL/min since drug exposure is increased. Periodically assess renal function as clinically indicated (i.e., more frequently in situations in which renal function may decline) and adjust therapy accordingly. Discontinue XARELTO in patients who develop acute renal failure while on XARELTO.
  • For patients with CrCl >50 mL/min: 20 mg orally, once daily with the evening meal
  • For patients with CrCl 15 - 50 mL/min: 15 mg orally, once daily with the evening meal

Treatment of Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), and Reduction in the Risk of Recurrence of DVT and of PE:   Avoid the use of XARELTO in patients with CrCl <30 mL/min due to an expected increase in rivaroxaban exposure and pharmacodynamic effects in this patient population.

Prophylaxis of Deep Vein Thrombosis Following Hip or Knee Replacement Surgery:  Avoid the use of XARELTO in patients with CrCl <30 mL/min due to an expected increase in rivaroxaban exposure and pharmacodynamic effects in this patient population. Observe closely and promptly evaluate any signs or symptoms of blood loss in patients with CrCl 30 to 50 mL/min. Patients who develop acute renal failure while on XARELTO should discontinue the treatment

HHemodialysis

dialysis Avoid use.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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