How to Take Xarelto Safely

Wednesday 30 January 2019
7 minute(s) read

Medically reviewed by

Stefan Reiner, PharmD, RPh
on 1 September 2020

Table of Contents

I. Considering Medications

a. What medications should not be taken with Xarelto?

b. Are there any medications you can take safely with Xarelto?

c. Do you have to check with your doctor to see what medications are safe?

II. Managing Your Diet

a. Are there any foods to avoid when taking Xarelto?

b. Why take Xarelto with food?

c. What happens if you take Xarelto without food?

d. Is there anything else you can do for your diet?

III. Timing Your Xarelto Intake

a. When to take Xarelto?

b. How long to take Xarelto for deep vein thrombosis and other conditions?

c. How long to stop Xarelto before surgery?

IV. Handling Poor Timing

a. What happens if you miss a dose of Xarelto?

b. What happens if you overdose?

V. Staying Safe

Just starting your Xarelto dose? Then, you may feel a little nervous. And that’s completely understandable! Starting a new medication can be intimidating. After all, even with guidance from your doctor, you have a lot of new information to keep in mind. And that information can often be crucial to your health. Generic Xarelto, known as rivaroxaban, is now available at discount prices at Canada Pharmacy Depot. 

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Considering Medications

First, you might want to consider how Xarelto will react with other medications. Different medications have different ingredients. And those ingredients won’t always play nicely when they come into contact with others.

But how can you tell?

What medications should not be taken with Xarelto?

In short, you probably can’t tell what ingredients would react poorly together. You would likely need a doctor’s expertise. So your main plan should, at some point, be to ask your family physician.

In the meantime, however, consider the Institute for Safe Medication Practices’ guide. [1] It notes that you should probably avoid taking the following with Xarelto:

  • Nizoral tablets
  • Sporanox
  • Onmel
  • Norvir
  • Biaxin
  • Rifadin
  • Dilantin
  • Tegretol
  • Lexapro
  • Prozac
  • Zoloft
  • Paxil
  • Cymbalta
  • Effexor XR
  • Eliquis
  • Pradaxa
  • Savaysa
  • Coumadin
  • Jantoven
  • Lovenox
  • Heparin

Are there any medications you can take safely with Xarelto?

The guide does also mentions that there are medications you can take with Xarelto. But you should only do so if your doctor prescribes them. These include:

  • Aspirin
  • Any products with aspirin in them
  • Non-steroidal anti-inflammatory drugs, such as Motrin, Advil, and Aleve
  • Blood-thinning herbals and vitamins, such as St. John’s wort, feverfew, and similar items


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Do you have to check with your doctor to see what medications are safe?

To be absolutely sure of what’s safe for you, ask your doctor. Otherwise, you could run the risk of encountering health concerns like: 

  • Increasing the risk of side effects
  • Decreasing drug effectiveness
  • Having problems with bleeding [2]

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Managing Your Diet

But you shouldn’t just keep an eye on what medications you take. You should also take the time to consider your diet.

Are there any foods to avoid when taking Xarelto?

Luckily, Xarelto is advertised as not having any known dietary restrictions! [3] A little surprising, right? After all, other blood thinner meds like Coumadin do have some restrictions. Mainly, patients would need to eat fewer foods with vitamin K. [4] So they would have to be careful around foods like asparagus, broccoli, and spinach.

This is because a high enough intake of vitamin K would counteract the effects of the blood thinners. But with Xarelto, you don’t need to worry about this!

Why take Xarelto with food?

In fact, you’re encouraged to take Xarelto with food.


Well, your body usually can’t absorb the whole dose of Xarelto without it! [5] So be sure to take your dose of Xarelto after a meal or snack. It’s suggested by the NHS that you should try to do this at the same time every day.

What happens if you take Xarelto without food?

If your doctor mentions that it’s fine to take Xarelto with or without food, follow their advice. It might seem contrary to what we just said previously. But there are cases where food doesn’t necessarily have to go with Xarelto. For instance, you’re actually perfectly fine if you take a 2.5 mg or 10 mg tablet without food.

But as The Mayo Clinic points out, you’ll still need to take food with tablets of 15 mg or higher. [6]

Is there anything else you can do for your diet?

While Xarelto doesn’t have dietary restrictions, your body may benefit from some. After all, Xarelto is there to protect you from blood clots and strokes. And a specific diet can help strengthen that protection! All you need to do is apply the following dietary tips:

Keep a heart-healthy diet It will not only help you lower your blood pressure and cholesterol. It will also help you manage your weight and reduce your risk of diabetes. To start this diet, you’ll want to:

  • Minimize eating unhealthy fats and sodium
  • Stay away from any sugary or processed foods
  • Focus on eating more fruits and vegetables
  • Add whole grains and low-fat protein sources to your diet

Portion your meals properly Most of you may not realize this, but portion sizes have changed quite a bit over the years. In fact, they’ve doubled during the last 20 years or so! But if you follow these guidelines, you should end up with proper portions:

  • 3 oz. of lean protein (such as chicken or fish) should be the same size as a deck of cards
  • 1 cup of fresh fruit or vegetables should amount to the size of a tennis ball
  • 1 serving of foods with starch (such as potatoes, rice, or pasta) should be as big as a single ice cream scoop
  • 1 oz. of peanut butter or cheese should be the size of your thumb

Prepare your meals ahead of time It’s much easier to manage what you eat and the portions if you plan out your meals. So think about creating a menu for the week to keep on top of your heart-healthy diet.

Try to drink alcohol sparingly Unfortunately, alcoholic beverages can be high in calories. And they can offer other negative health effects too. So if you’re a woman, avoid drinking more than one beverage a day. If you’re a man, try to avoid drinking more than two. [7]

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Timing Your Xarelto Intake

You’ll also want to consider the timing when it comes to Xarelto. It can be crucial for effective healthcare.

When to take Xarelto?

If you want the most out of your Xarelto supply, consider taking your doses in the evening. Several Vienna researchers noted that an evening intake prolongs your exposure to Xarelto. This sounds like a problematic issue. But it’s actually good as it matches the body’s low rate of blood clot breakdown in the morning. [8]

How long to take Xarelto for deep vein thrombosis and other conditions?

You’ll want to be doing evening doses for a number of times no matter the condition you’re treating. However, the exact length of time will depend on what you’re treating:

  • Knee or hip joint operation: two to five weeks
  • A blood clot from deep vein thrombosis or pulmonary embolism: 3 months or longer
  • Heart problems from atrial fibrillation or a heart attack: longer than three months and possibly for life

How long to stop Xarelto before surgery?

Because Xarelto can make you bleed too easily, you may need to stop your particular dose before undergoing medical procedures. Depending on how severe your procedure is, you may want to stop Xarelto 24 hours or more ahead of time. [9]

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Handling Poor Timing

But what do you do if you’ve made a mistake with timing your Xarelto dose? Don’t panic yet! Just consider the following facts.

What happens if you miss a dose of Xarelto?

Likely, you won’t notice anything if you’ve only missed one dose. If you take Xarelto once daily and you still have more than 12 hours before your next dose, try to take that missed dose as soon as you can. But if it’s fewer than 12 hours, just skip that dose. For patients taking 15 mg twice daily, the patient should take a dose immediately to ensure an intake of 30 mg/day. Two 15 mg tabs may be taken at once. [10]

What happens if you overdose?

Be careful not to double your dose accidentally!

Overdosing of any kind can lead to hemorrhage if you’re not careful. [11]

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Staying Safe

Keeping all this in mind should help you stay safe when taking Xarelto. But if you’re ever concerned about how you’re taking Xarelto, let your doctor know immediately. They are there to look after your health, and they have in-depth knowledge to help them do so.

Want to learn more about Xarelto? Then, take a look at our other Xarelto articles. (In particular, you may want to read our detailed explainer on the medication’s definition and use!)

DISCLAIMER: The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.


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