Side effects of rivaroxaban

Even though rivaroxaban (Xarelto) has been tested in clinical trials, it is a fairly new medicine and its full range of side effects is still being understood.

See your doctor straight away if you have any changes in your health or unusual symptoms after starting rivaroxaban.

Bleeding

Bleeding is one of rivaroxaban’s side effects and it can sometimes be life threatening.

Bleeding seems as likely to occur with rivaroxaban as it is with warfarin. However, unlike warfarin there is currently no specific antidote for rivaroxaban to stop bleeding. So if you do have a serious bleed while you are taking rivaroxaban, it may take longer to treat.

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.

It is important to know the signs and symptoms of bleeding. Some signs of bleeding may not be obvious, particularly internal bleeding, so it’s important to know what these are.

If you are taking rivaroxaban because you’ve had knee or hip replacement surgery, you may find that some blood seeps through the dressing after your operation. Some seepage is normal, but if you think that the bleeding is excessive, speak to your doctor about it.

Ask your doctor which signs of bleeding you should be aware of and when to seek urgent medical assistance.

A serious fall or injury may result in internal bleeding that is not obvious. Report any injuries to your doctor — including falls, cuts and scratches, bruising and accidents — even when you don’t notice any bleeding.

If you are not sure if you need urgent treatment, call healthdirect Australia on 1800 022 222, and speak to a registered nurse who can help you decide.

Signs and symptoms of bleeding

Some signs and symptoms of bleeding include:

  • bruising that occurs easily or takes longer than normal to heal
  • red or dark brown urine
  • red or black bowel motions
  • nosebleeds — particularly when they occur more frequently or take longer than normal to stop
  • trouble breathing or swallowing
  • coughing up blood
  • heavier than usual menstrual periods
  • bleeding from cuts, wounds and scrapes that takes too long to stop
  • dark or blood-stained vomit
  • severe headache or dizziness
  • unexplained shock, paleness or weakness
  • unexplained pain, swelling or discomfort.

A serious fall or injury may result in internal bleeding that is not obvious. Report any injuries to your doctor — including falls, cuts and scratches, bruising and accidents — even when you don’t notice any bleeding.

Other side effects of rivaroxaban

Other side effects you may experience include:

  • nausea (feeling sick)
  • tiredness
  • dizziness.

For a list of possible side effects, see the consumer medicine information (CMI) for rivaroxaban (Xarelto) available from this website or your pharmacist. Keep the CMI to refer to later if you need to. You can also ask your doctor about the possible side effects of rivaroxaban before you take it.

Who can I ask about side effects?

If you're concerned that you or someone in your care may have had side effects related to a medicine, seek medical advice. People with questions about their medicines or seeking general information about side effects can also call the NPS Medicines Line on 1300 633 424 (Monday–Friday, 9am–5pm AEST). To report possible side effects call the Adverse Medicine Events (AME) Line on 1300 134 237 from anywhere in Australia (Monday–Friday, 9am–5pm AEST).

References