What is rivaroxaban (Xarelto)?
- prevent stroke in people with a heart condition called atrial fibrillation who also have at least one other risk factor for stroke, such as diabetes or high blood pressure
- prevent serious blood clots (venous thromboembolism or VTE) from forming after hip or knee replacement surgery
- treat deep vein thrombosis (DVT; a blood clot in a deep vein of the leg) and pulmonary embolism (PE; a blood clot in the luns)
- prevent another DVT or PE if you have had one before.
How does it work?
Rivaroxaban prevents blood clots from developing by blocking a protein in the blood called Factor Xa, a substance that is important for forming blood clots.
Anticoagulants like rivaroxaban are sometimes called ‘blood thinners’, but this is not how they actually work. They do not make your blood thinner, but instead cause it to take longer to clot.
Find out more about anticoagulants.
Benefits of rivaroxaban (Xarelto)
Rivaroxaban can help save lives by reducing the chance of harmful and sometimes life-threatening blood clots forming and preventing stroke, DVT and PE.
However, like all anticoagulants, the main side effect of rivaroxaban is bleeding. 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.
Because rivaroxaban is a tablet, it can be a suitable choice for people who are unable to manage anti-clotting medicines that need to be injected, such as enoxaparin (Clexane). Find out more about who can take rivaroxaban and other medicine choices.
Discuss the advantages and disadvantages of rivaroxaban compared with other medicines (e.g. warfarin) with your doctor. Find out more about warfarin.
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