What Is Xarelto, and What Is It Used For?

Thursday 30 May 2019
6 minute(s) read

Medically reviewed by

Stefan Reiner, PharmD, RPh
on 1 September 2020

Table of Contents

I. What is Xarelto used for?

a. Xarelto for DVT

b. Xarelto for Pulmonary Embolism

c. Xarelto for AFib

II. How does Xarelto work?

III. Benefits of Xarelto

a. Xarelto vs. Warfarin

b. Xarelto vs. Eliquis and Pradaxa

IV. Xarelto Cautions

a. Xarelto Side Effects

b. Xarelto Overdose

c. Things to Avoid

Xarelto, also known by its generic name rivaroxaban, is an oral therapy used to prevent blood clots. Xarelto and generic Xarelto is a factor Xa inhibitor that reduces the body’s ability to form clots. Rivaroxaban is a newer generation of anticoagulants that offers fewer interactions and increased efficacy. Read on to learn everything you need to know about this powerful blood thinner.

What is Xarelto used for?

Rivaroxaban is typically used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). By lowering the risk of developing a blood clot, it is also used to prevent strokes in patients who have atrial fibrillation (AFib) who don’t have a heart valve problem. If you are wondering, "when will Xarelto go generic?" you’re in luck because generic Xarelto is now available on Canada Pharmacy Depot.

a. Xarelto for DVT

Deep vein thrombosis (DVT) is when a blood clot forms in a vein deep, usually in the lower body. This can happen if a vein is damaged, especially through either injury or after surgery in the hip or legs. A DVT can be life-threatening because a clot in a deep vein can rupture and travel to the lungs or the brain, leading to a pulmonary embolism or a stroke. [1]

Close-up of fingers being wrapped in white bandage.

To treat DVT, your doctor may prescribe Xarelto 15mg twice a day for the first three weeks. After this initial dose, your doctor will likely switch you to a maintenance dose of 20mg, once a day until you are no longer at risk of blood clots. Patients with a history of deep vein thrombosis are at risk of this condition recurring. Xarelto can be used to prevent recurrent DVT. A prevention-focused treatment typically involves Xarelto 10mg, once a day.

b. Xarelto for pulmonary embolism

A pulmonary embolism (PE) occurs when a clot develops in the lungs, causing a dangerous blockage that reduces oxygen circulation. Low oxygen levels can lead to permanent organ damage. If the clot is large or there is more than one clot, PE can be potentially fatal. The recommended dosage of Xarelto for PE and DVT are the same: 15mg twice a day to start and 20mg once a day for continual blood clot prevention.

Your risk of a pulmonary embolism is significantly higher after a hip or knee replacement surgery. To manage your post-surgery risk, Xarelto 10mg can be prescribed once a day for 12 to 35 days, depending on the type of surgery. Within 6 to 10 hours after a procedure, your doctor will determine your blood clot risk and whether you should start taking rivaroxaban. Before starting Xarelto, your physician will ensure the bleeding from the surgery has stopped. [2]

c. Xarelto for AFib

Atrial fibrillation (also known as AFib) is a heart rhythm disorder where your heart beats faster than it should. AFib happens when the heart’s upper (atria) and lower (ventricle) chambers don’t co-operate: the ventricles do not fill fully with blood or do not pump enough blood throughout the body. This lack of oxygen circulating throughout the body causes the patient to experience fatigue or dizziness or to suffer chest pains and palpitations. But sometimes, atrial fibrillation shows no symptoms at all. [2]

A collection of storage tubes for drawn blood with different coloured caps (blue, black, red, purple, gray) on a teal background.

How does Xarelto work?

Xarelto belongs to a family of medications known as blood thinners or anticoagulants. They interrupt the clotting mechanisms in your blood, making your blood clot more slowly.

Clotting is a complex process that requires a variety of substances called clotting factors produced in the liver, which work with platelets. One of the most important factors is factor Xa. Rivaroxaban blocks factor Xa from working properly, preventing the blood from clotting as easily. [2]

Benefits of Xarelto 

Xarelto is a newer anticoagulant. An older anticoagulant that is often compared to Xarelto is warfarin, sometimes known by the brand name Coumadin. Before starting treatment you may want to talk to your doctor to ensure it is right for you or if you may need Xarelto alternatives. 

a. Xarelto vs. Warfarin

Xarelto and warfarin treat similar things but work quite differently. Xarelto only blocks factor Xa, but warfarin affects at least six factors as well as vitamin K.

The most significant advantage of Xarelto over warfarin is that Xarelto does not require regular blood testing or significant dietary restrictions. However, warfarin treatment may require regular blood testing and adjusting one’s diet. People taking warfarin should talk to their doctors about eating leafy green vegetables high in vitamin K, as well as grapefruit juice. So, Xarelto may be more advantageous simply because it’s more convenient.

b. Xarelto vs. Eliquis and Pradaxa 

Eliquis (apixaban) and Pradaxa (dabigatran) are similar drugs to Xarelto in that they all belong to a drug family known as direct oral anticoagulants (DOAC). These medications are similarly effective at preventing blood clots, and all three medications increase the risk of bleeding, spinal blood clots, and blood clots if you stop treatment. However, Eliquis and Pradaxa are more likely to cause certain side effects than Xarelto, including nausea and fainting. Additionally, Xarelto works by preventing the body from forming the clotting factor called thrombin, but Pradaxa works by inhibiting the action of this enzyme after it is formed. [3]

Xarelto Infographic

Xarelto Cautions

There are benefits and risks to almost every medical treatment, but if your doctor prescribed you a Xarelto dose, it means they’ve determined that the benefits of Xarelto outweigh the risks.

Discuss possible side effects and adverse drug interactions with your doctor and be sure to ask questions if you don’t understand something. It is essential that you know how to take Xarelto before beginning treatment.

a. Xarelto side effects

Rivaroxaban can cause uncomfortable side effects, such as muscle spasms. However, if you notice any of the following symptoms, the U.S. National Library of Medicine recommends finding medical help immediately:

  • Black, bloody, or tarry stools and/or discolored (brown or pink) urine
  • Vomit that resembles coffee grounds
  • Rashes, itching, and/or hives
  • Weakness, fatigue
  • Excessive bleeding, such as heavy menstruation, frequent nosebleeds, and bleeding gums
  • Pain in the limbs
  • Breathing and/or swallowing difficulties
  • Headaches
  • Dizziness, fainting
  • Pain or swelling at wounds
  • Blurry vision [3]

Please note that this list of side effects is not exhaustive. Other side effects may happen to you. If in doubt, call a medical professional.

b. Xarelto overdose

Signs you may have taken too much rivaroxaban include:

  • Unusual bruising and/or bleeding
  • Bloody urine and/or bloody, black, or tarry stools
  • Vomit that looks like coffee grounds [4]

Again, these symptoms are not exhaustive. To prevent children and pets from accidentally ingesting this medicine, keep your pills in child-proof containers and out of reach.

c. Things to avoid

Sometimes, different medications are dangerous if they interact with each other within the body. Before starting any new medications such as Xarelto 10 mg, make sure you tell your doctor all other medications you use. Tell your doctor about:

  • Other prescription medications you take
  • Over-the-counter medications you take
  • Recreational drugs you may consume
  • Vitamins, supplements, and herbs you 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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