Living with rivaroxaban
If you’ve been prescribed rivaroxaban (Xarelto), take it for as long as your doctor recommends and exactly as directed. Taking the correct dose for the right amount of time will help to prevent any dangerous blood clots occurring during your recovery.
If you are recovering from hip or knee replacement surgery, your doctor may recommend you wear compression stockings while you are recovering to further reduce your risk of blood clots.
You will also be given a program of exercises to help with your recovery.
If you have atrial fibrillation, your doctor may prescribe other treatments along with rivaroxaban to reduce the risk of stroke, to try and manage the other symptoms of your condition, like the fast and irregular heartbeat. Find out more about atrial fibrillation and stroke.
Find out more about diet and warfarin.
Alcohol can increase the risk of bleeding when taking anticoagulants — so it is best to limit your alcohol intake to no more than 2 standard drinks of alcohol per day and avoid binge drinking. (The Australian Government Department of Health explains what is meant by an Australian Standard Drink.) Ask your health professional for advice.
Warfarin is currently the anticoagulant most often used for preventing strokes in people with atrial fibrillation. However, unlike warfarin, there is currently no equivalent of the INR blood test to monitor rivaroxaban’s effect on blood clotting, or to inform any dose changes.
Some people will prefer rivaroxaban as they won’t have to have ongoing monitoring. For others, the regular INR blood tests that are needed to monitor how well warfarin is working may be reassuring, since it is an easy way to tell if you are at risk of bleeding, and if a dose change is required.
Bleeding seems as likely to occur with rivaroxaban as it is with warfarin. However, unlike warfarin there is currently no specific antidote to rivaroxaban to stop the bleeding. So if you do have a serious bleed while you are taking rivaroxaban, it may take longer to treat.
If you are taking rivaroxaban you will still need to have regular check ups, and blood tests to check your kidney function before you start rivaroxaban and at least once per year if you are taking it long-term.
Discuss the advantages and disadvantages of rivaroxaban compared with other medicines (e.g. warfarin) with your doctor. Find out more about warfarin.
Reduce the risk of bleeding
As with any anticoagulant medicine, rivaroxaban can cause serious bleeding. To reduce the risk you should:
- go to the emergency department of your nearest hospital if you have any prolonged or excessive bleeding, signs of internal bleeding (e.g. blood in your urine, or coughing up blood) or if you’ve hit your head
- report any falls to your doctor — even if there are no visible signs of bleeding — and discuss ways to reduce the risk of falls
- reducing your risk of injury — for example, by avoiding contact sports, wearing gloves when gardening, making adjustments around the home to reduce your risk of falls, using an electric shaver, brushing your teeth with a soft-bristled toothbrush
- consult your doctor or pharmacist before starting any new medicines, including vitamins or over-the-counter medicines, as these may interact with rivaroxaban
- tell all the health professionals involved in your care (including surgeons, dentists and naturopaths) that you are taking rivaroxaban - this will help to identify any potential interactions with other medicines
- let your health professional know that you are taking rivaroxaban before surgery or dental procedures, as they may need to temporarily suspend your treatment.
Find out more about rivaroxaban
- Rossi S, ed. eAMH [online]. Australian Medicines Handbook, January 2013. www.amh.net.au (accessed June 2013).
- Cardiovascular Expert Group. Therapeutic guidelines: cardiovascular. Therapeutic Guidelines Ltd; 2013. www.tg.org.au (accessed June 2013).
- NPS Medicine Update, April 2010. Rivaroxaban (Xarelto) for preventing blood clots after hip or knee replacement surgery
- NPS Medicine Update, December 2012. Rivaroxaban (Xarelto) for preventing stroke in people with atrial fibrillation