Rivaroxaban(riv’ a rox’ a ban)
Xarelto
PREGNANCY CATEGORY C
Drug Classes
Anticoagulant
Factor Xa inhibitor
Therapeutic Actions
Factor Xa inhibitor that selectively blocks the active site of factor Xa and does not require a cofactor for activity; factor Xa plays a central role in the blood coagulation cascade.
Indications
Prophylaxis of DVT, which may lead to pulmonary embolism in patients undergoing knee or hip replacement surgery
Reduction of risk of stroke in patients with nonvalvular atrial fibrillation (AF)
Treatment of deep vein thrombosis (DVT) and pulmonary embolism
Reduction of the risk of recurrent DVT and pulmonary embolism following initial treatment
Contraindications and Cautions
Contraindicated with known hypersensitivity to components of the drug; active pathologic bleeding, severe renal impairment, moderate to severe hepatic impairment.
Use cautiously with invasive procedures, surgery, pregnancy, lactation.
Available Forms
Tablets—10, 15, 20 mg
Dosages
Adults
Prophylaxis of DVT: 10 mg/day PO without regard to food. Start dosing within 6–10 hr of surgery; continue for 35 days after hip replacement, 12 days after knee replacement.
Treatment of DVT, PE: 15 mg PO bid for 21 days; maintenance, 20 mg/day PO.
Reduction of risk of recurrent DVT, PE: 20 mg/day PO.
Nonvalvular AF: 20 mg/day PO with evening meal.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
For CrCl of more than 15 mL/min but less than 50 mL/min, monitor patient closely for signs of bleeding; maximum dose, 15 mg/day for AF. Avoid use if CrCl is less than 15 mL/min.
Patients with hepatic impairment
Avoid use in patients with moderate to severe hepatic impairment (Child-Pugh score B or C) or with hepatic disease associated with coagulopathy.
Pharmacokinetics
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