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rivaroxaban

Pronunciation: RIV a ROX a ban
Brand: Xarelto

What is the most important information I should know about rivaroxaban?

emt Rivaroxaban can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you have a genetic spinal defect, a history of spinal surgery or repeated spinal taps, or if you are using other medications to treat or prevent blood clots. Symptoms of this type of blood clot include numbness, tingling, muscle weakness, or loss of movement. Tell any doctor who treats you that you are using rivaroxaban.
donot Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding or life-threatening blood clots, and it is very important to tell your doctor about all medicines you have recently used.
emt Tell your caregivers at once if you have signs of bleeding such as black or bloody stools, coughing up blood, confusion, feeling like you might pass out, or any bleeding that will not stop.

Blood clots around the brain or spinal cord may occur if you use rivaroxaban with other drugs that can affect blood clotting, including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin, and any other medications to treat or prevent blood clots.

donot Do not stop taking this medication without first talking to your doctor. Stopping suddenly can increase your risk of blood clot or stroke.

What is rivaroxaban?

Rivaroxaban is an anticoagulant (blood thinner) that prevents the formation of blood clots.

Rivaroxaban is used to prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery.

Rivaroxaban is also used in people with atrial fibrillation (a heart rhythm disorder) to lower the risk of stroke caused by a blood clot.

Rivaroxaban may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking rivaroxaban?

donot You should not use this medication if you are allergic to rivaroxaban, or if you have active or uncontrolled bleeding.
emt Rivaroxaban can cause a very serious blood clot around your brain or spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term paralysis, and may be more likely to occur if you have:
  • a genetic spinal defect;
  • a history of spinal surgery or repeated spinal taps; or
  • if you are using other medications to treat or prevent blood clots.

Rivaroxaban may cause you to bleed more easily, especially if you have:

  • a bleeding disorder that is inherited or caused by disease;
  • hemorrhagic stroke;
  • uncontrolled high blood pressure; or
  • stomach or intestinal bleeding or ulcer.

To make sure you can safely take rivaroxaban, tell your doctor if you have kidney or liver disease.

nopreg FDA pregnancy category C. It is not known whether rivaroxaban will harm an unborn baby. However, this medicine could cause bleeding complications during childbirth. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
nobrfeed It is not known whether rivaroxaban passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using rivaroxaban.

How should I take rivaroxaban?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Rivaroxaban is usually taken once per day. Follow your doctor's instructions.

For hip or knee replacement surgery: You may take rivaroxaban with or without food.

For atrial fibrillation: Take rivaroxaban with your evening meal.

emt Tell any doctor who treats you that you are using rivaroxaban. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication. If you need anesthesia for a medical procedure or surgery, you may need to stop using rivaroxaban for a short time.

Use rivaroxaban regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

donot Do not stop taking this medication without first talking to your doctor. Stopping suddenly can increase your risk of blood clot or stroke.
rt Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Take your next dose the following day and stay on your once-daily schedule. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

emt Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause excessive bleeding.

What should I avoid while taking rivaroxaban?

donot Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

What are the possible side effects of rivaroxaban?

emt Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
donot Stop using rivaroxaban and call your doctor at once if you have a serious side effect such as:
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
  • heavy menstrual periods;
  • headache, dizziness, weakness, feeling like you might pass out;
  • red or pink urine;
  • black or bloody stools, coughing up blood or vomit that looks like coffee grounds;
  • numbness, tingling, or muscle weakness (especially in your legs and feet); or
  • loss of movement in any part of your body.

Less serious side effects may include:

  • muscle pain;
  • itching; or
  • pain in your arms or legs.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect rivaroxaban?

Tell your doctor about all other medicines you use, especially:

  • bosentan (Tracleer);
  • conivaptan (Vaprisol);
  • dexamethasone (Cortastat, Dexasone, Solurex, DexPak);
  • rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin);
  • St. John's wort;
  • quinidine (Quin-G);
  • verapamil (Calan, Covera, Isoptin, Verelan);
  • an antibiotic such as azithromycin (Zithromax), clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole);
  • antifungal medication such as itraconazole (Sporanox) or ketoconazole (Nizoral);
  • a barbiturate such as butabarbital (Butisol), secobarbital (Seconal), pentobarbital (Nembutal), or phenobarbital (Solfoton);
  • heart or blood pressure medication such as reserpine, amiodarone (Cordarone, Pacerone), diltiazem (Cartia, Cardizem), dronedarone (Multaq), felodipine (Plendil), quinidine (Quin-G), or verapamil (Calan, Covera, Isoptin, Verelan);
  • HIV medication such as efavirenz (Sustiva, Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);
  • medicines to treat narcolepsy, such as armodafinil (Nuvigil) or modafinil (Progivil);
  • medicines used to prevent organ transplant rejection, such as cyclosporine (Gengraf, Neoral, Sandimmune) or tacrolimus (Prograf); or
  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), phenytoin (Dilantin), or primidone (Mysoline).
emt Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding, and it is very important to tell your doctor about all medicines you have recently used. Bleeding or blood clots around the brain or spinal cord may occur if you use rivaroxaban with other drugs that can affect blood clotting, such as:
  • abciximab (ReoPro), eptifibatide (Integrelin), ticagrelor (Brilinta), tirofiban (Aggrastat);
  • cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine, Aggrenox), prasugrel (Effient), ticlopidine (Ticlid);
  • dalteparin (Fragmin), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, tinzaparin (Innohep), warfarin (Coumadin, Jantoven);
  • argatroban (Acova), bivalirudin (Angiomax), lepirudin (Refludan);
  • alteplase (Activase), tenecteplase (TNKase), urokinase (Abbokinase);
  • an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;
  • salicylates such as aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.

This list is not complete and other drugs may interact with rivaroxaban. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about rivaroxaban.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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