Xarelto belongs to a class of prescription medications called anticoagulants, commonly known as blood thinners. Xarelto contains the active ingredient rivaroxaban. Tablets are available and are primarily used to prevent or treat blood clots in people at risk of deep vein thrombosis (DVT), pulmonary embolisms (PE), strokes, and atrial fibrillation.

A wide range of individuals who require anticoagulant therapy take Xarelto. People who may benefit from Xarelto include:

  1. Patients with atrial fibrillation: An irregular and rapid heartbeat is a characteristic of atrial fibrillation. Xarelto prevents blood clots from forming in people with AFib. Due to the formation of blood clots, atrial fibrillation increases the risk of stroke. Patients with AFib are prescribed Xarelto to prevent strokes.
  2. Individuals undergoing knee or hip replacement surgery: Blood clots are more likely to occur after joint replacement surgery. Blood clots in the legs are commonly prevented with Xarelto after these procedures.
  3. Patients with deep vein thrombosis (DVT): Blood clots form in deep veins of the body, usually in the legs, when deep vein thrombosis occurs. Blood clots in deep veins (DVT) can be treated with Xarelto and prevented from recurring. As well as reducing the risk of pulmonary embolism in high-risk patients, it is also prescribed to avoid strokes.
  4. People at risk of pulmonary embolism (PE): A pulmonary embolism occurs when a blood clot travels to the lungs, posing a life-threatening threat. Patients at risk of PE are prescribed Xarelto to reduce their risk.

Warnings and Precautions

Xarelto is a potent medication that carries certain risks and precautions. It is crucial to be aware of these warnings and take appropriate measures when using this medication. Here are some important points to consider:

Pre-existing Conditions

Before starting Xarelto treatment, it is essential to inform your healthcare provider about any pre-existing medical conditions you may have. Informing your healthcare provider about these conditions will help determine the appropriate dosage and closely monitor any potential side effects or complications. Certain conditions may increase the risk of complications when taking Xarelto. These conditions include:

  • Liver disease
  • Kidney disease
  • History of bleeding disorders
  • Active ulcerative gastrointestinal disease
  • Recent surgery or injury
  • High blood pressure

Bleeding Risks

One of the significant risks associated with Xarelto is the increased likelihood of bleeding. Xarelto works by inhibiting the blood’s ability to clot, which is beneficial for preventing blood clots but can also lead to bleeding complications. It is crucial to be aware of the signs of bleeding and seek immediate medical attention if any of the following occur:

  • Unexplained or excessive bruising
  • Frequent nosebleeds
  • Blood in urine or stools
  • Unusual bleeding from cuts or injuries
  • Prolonged bleeding after surgery or dental procedures

Elderly Patients

Patients who are elderly may be more susceptible to the side effects of Xarelto, including bleeding. This population requires close monitoring to ensure the medication’s safety and effectiveness. Healthcare providers may adjust the dosage or prescribe additional medications to mitigate the risks associated with Xarelto.

Side Effects

Xarelto is a blood-thinning medication that works by inhibiting a specific clotting factor in the blood. While it is generally well-tolerated by most patients, some individuals may experience side effects. If you experience any side effects while taking Xarelto, consult your healthcare provider promptly. Your doctor can provide guidance and determine the best course of action to ensure your safety and well-being. Here are the common, rare, and severe side effects of Xarelto:

Common Side Effects

  1. Gastrointestinal Disturbances: Many patients taking Xarelto may experience gastrointestinal issues such as nausea, vomiting, and indigestion. These symptoms are usually mild and temporary.
  2. Bruising and Bleeding: Xarelto’s blood-thinning properties can increase the risk of bruising and bleeding. Minor bruising is common, but if you notice any unusual bleeding or prolonged bleeding from a cut, it is essential to seek medical attention.
  3. Dizziness: Some patients may experience dizziness or lightheadedness while taking Xarelto. This side effect is usually temporary and resolves on its own.
  4. Headache: Headaches are a common side effect of Xarelto. They are generally mild and go away without any specific treatment.

Rare Side Effects

  1. Allergic Reactions: Although rare, some individuals may develop an allergic reaction to Xarelto. Signs of an allergic reaction include rash, itching, swelling, severe dizziness, and difficulty breathing. If you experience any of these symptoms, seek immediate medical help.
  2. Liver Problems: In rare cases, Xarelto has been associated with liver-related complications. If you notice symptoms such as yellowing of the skin or eyes, dark urine, or persistent abdominal pain, contact your healthcare provider.
  3. Muscle Pain: Xarelto can cause muscle pain or muscle weakness in some individuals. If you experience persistent muscle pain or weakness, consult your doctor.

Severe Side Effects

  1. Uncontrolled Bleeding: The most severe and potentially life-threatening side effect of Xarelto is uncontrolled bleeding. While Xarelto helps prevent blood clots, it can also increase the risk of excessive bleeding. Signs of severe bleeding include coughing up blood, blood in urine or stool, prolonged nosebleeds, and heavy menstrual bleeding. If you experience any of these symptoms, seek immediate medical attention.
  2. Spinal or Epidural Hematoma: Rarely, Xarelto can cause a spinal or epidural hematoma, which is a blood clot that forms near the spine. This condition can lead to paralysis if not treated promptly. Seek medical help if you experience severe back pain, numbness or weakness in the lower limbs, or difficulty controlling bladder or bowel function.


Drug interactions occur when two or more substances interact with each other, affecting the way they work in the body. These interactions can result in various outcomes, including:

  1. Increased or decreased effectiveness of the medication
  2. Enhanced or diminished side effects
  3. Altered metabolism and elimination of the medication

It’s crucial to be aware of potential drug interactions to ensure the safe and effective use of Xarelto. Let’s explore some common drug interactions with Xarelto and the precautions you should take.

Common Medications

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs, such as ibuprofen and naproxen, are commonly used to relieve pain and reduce inflammation. However, when taken concurrently with Xarelto, NSAIDs can increase the risk of bleeding. Both Xarelto and NSAIDs have anticoagulant effects, and their combined use can intensify this effect, potentially leading to excessive bleeding. It’s important to consult your healthcare provider before taking NSAIDs while on Xarelto.
  • Antiplatelet Medications: Antiplatelet medications, such as aspirin and clopidogrel, are prescribed to prevent blood clots in individuals with certain cardiovascular conditions. When taken together with Xarelto, the risk of bleeding may increase. Your healthcare provider will carefully assess the potential benefits and risks before prescribing these medications together.
  • Anticoagulant Medications: Combining Xarelto with other anticoagulant medications, such as warfarin or heparin, can significantly increase the risk of bleeding. The concurrent use of multiple anticoagulants should be avoided unless specifically directed by your healthcare provider. Regular monitoring of blood clotting parameters may be necessary in such cases.
  • Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SSRIs and SNRIs are commonly prescribed for the treatment of depression, anxiety, and other mental health conditions. When taken with Xarelto, these medications can increase the risk of bleeding. It’s essential to inform your healthcare provider if you are taking any antidepressant medications before starting Xarelto.

Herbal Supplements

  • St. John’s Wort: St. John’s Wort is a popular herbal supplement used for the treatment of depression and other mood disorders. However, it can interact with Xarelto, reducing its effectiveness. The combination of St. John’s Wort and Xarelto can increase the risk of blood clots and compromise the therapeutic benefits of Xarelto. It’s important to inform your healthcare provider if you are taking St. John’s Wort or any other herbal supplements.
  • Garlic: Garlic supplements are often used for their potential cardiovascular benefits. However, garlic can also affect blood clotting. When taken with Xarelto, the risk of bleeding may increase. If you are using garlic supplements, it’s advisable to discuss it with your healthcare provider to evaluate the potential risks and benefits.

Food Interactions

  • Grapefruit Juice: Grapefruit juice can interact with various medications, including Xarelto. It contains compounds that inhibit the enzymes responsible for metabolizing certain medications, leading to increased blood levels of the medication. This can enhance the anticoagulant effect of Xarelto, potentially increasing the risk of bleeding. It’s advisable to avoid consuming grapefruit juice while taking Xarelto.
  • Alcohol: While moderate alcohol consumption is generally considered safe for individuals taking Xarelto, excessive alcohol intake can increase the risk of bleeding. Alcohol has blood-thinning properties and can amplify the anticoagulant effects of Xarelto. It’s important to consume alcohol in moderation and consult your healthcare provider regarding any concerns.


The safety of taking Xarelto during pregnancy or when planning to become pregnant is a matter of concern for both patients and healthcare professionals. The use of any medication during pregnancy should be approached with caution, as there are potential risks involved. When it comes to Xarelto, the situation is no different.

While studies specifically examining the effects of Xarelto on pregnant women are limited, animal studies have shown adverse effects on the fetus, including an increased risk of developmental abnormalities and post-implantation pregnancy loss. Based on these findings, the use of Xarelto is generally not recommended during pregnancy.

In most cases, it is advised to avoid taking Xarelto if you are pregnant. The potential risks to the fetus outweigh the benefits of using the medication. If you have been taking Xarelto and discover that you are pregnant, it is important to consult your healthcare provider immediately. They will work with you to develop an appropriate plan for managing your condition while minimizing potential risks to you and your baby.

If you are planning on becoming pregnant and are currently taking Xarelto, it is crucial to discuss your plans with your healthcare provider. They will assess your individual circumstances and help determine the best course of action. In some cases, they may recommend transitioning to a different anticoagulant medication that is considered safer for use during pregnancy. It is essential to have open and honest communication with your healthcare provider to ensure the well-being of both you and your future child.


Xarelto is available in various dosage strengths to cater to the specific needs of patients. The dosages typically prescribed for Xarelto are 10 mg, 15 mg, and 20 mg. Each dosage strength is designed for different medical conditions and requires careful consideration by healthcare professionals. Let’s take a closer look at each dosage:

Xarelto 10 mg

Xarelto 10 mg is the lowest dosage strength available for this medication. It is commonly prescribed for reducing the risk of stroke in individuals with nonvalvular atrial fibrillation (AFib). Atrial fibrillation is an irregular heart rhythm that can increase the chances of blood clot formation. Xarelto 10 mg is usually taken once a day with or without food.

Xarelto 15 mg

Xarelto 15 mg is a dosage strength used for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients who have already been treated with an initial dose of a blood thinner. DVT refers to the formation of blood clots in the deep veins, usually in the legs, while PE occurs when a blood clot travels to the lungs. Xarelto 15 mg is typically taken twice a day for the initial treatment period, followed by Xarelto 20 mg once daily for continued treatment.

Xarelto 20 mg

Xarelto 20 mg is the highest dosage strength available for this medication. It is prescribed for the prevention of recurrent DVT and PE after an initial treatment period. Xarelto 20 mg is also used for reducing the risk of blood clots in patients undergoing hip or knee replacement surgery. It is usually taken once daily with or without food.


When discussing Xarelto overdose, it’s crucial to understand that this medication belongs to a class of drugs called anticoagulants, or blood thinners. Its primary function is to inhibit the formation of blood clots, thereby preventing complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). However, taking an excessive amount of Xarelto can lead to various complications and health risks.

Symptoms of Xarelto Overdose

The symptoms of a Xarelto overdose can vary depending on the severity and individual response to the medication. If you or someone you know experiences any of these symptoms after taking Xarelto, it is crucial to seek immediate medical attention. Some common signs to watch out for include:

  • Unusual bleeding, such as nosebleeds or bleeding gums
  • Excessive bruising
  • Blood in urine or stools
  • Vomiting blood
  • Fatigue and weakness
  • Dizziness or fainting
  • Rapid heartbeat

Treatment for Xarelto Overdose

In the case of a Xarelto overdose, prompt medical intervention is essential. The specific treatment approach may vary based on the severity of the overdose and the individual’s overall health condition. Here are some common steps that healthcare professionals may take to address a Xarelto overdose:

  1. Activated Charcoal: In certain cases, the administration of activated charcoal may be recommended to help prevent further absorption of the medication in the gastrointestinal tract.
  2. Inducing Vomiting: If the overdose occurred recently and the patient is conscious, inducing vomiting may be considered as a means to remove the excess Xarelto from the body.
  3. Supportive Care: Close monitoring of vital signs, blood tests, and other diagnostic measures will help healthcare providers assess the individual’s condition and provide appropriate supportive care.
  4. Blood Transfusion: In severe cases of Xarelto overdose where significant bleeding occurs, blood transfusions may be necessary to restore the blood’s ability to clot.

Missing a Dose 

These are general guidelines if you have missed a dose. We always suggest speaking to your healthcare provider about such instances and following their guidelines to the very best of your ability (and not reading something from a website).

  • The Importance of Adhering to the Dosage Schedule: When taking Xarelto, it is crucial to adhere to the prescribed dosage schedule provided by your healthcare professional. Missing a dose or altering the dosage without medical guidance can have significant implications for your health. It may increase the risk of blood clot formation and compromise the effectiveness of the medication.
  • Consequences of Missing a Dose: If you accidentally miss a dose of Xarelto, it is vital to take the missed dose as soon as you remember. However, if the next scheduled dose is due within the next 6 hours, it is advisable to skip the missed dose altogether and continue with the regular dosing schedule. Never take a double dose to compensate for the missed one.
  • Potential Effects on Clotting Risk: Missing a dose of Xarelto can lead to a temporary increase in clotting risk. This is because the anticoagulant effect of the medication gradually diminishes over time after the last dose. Therefore, it is crucial to maintain a consistent dosage regimen to ensure the continuous protection against blood clot formation.
  • Communicate with Your Healthcare Professional: If you happen to miss a dose of Xarelto or have concerns about the medication, it is important to promptly reach out to your healthcare professional. They are best equipped to provide guidance and advise you on the necessary steps to take. Remember, open and honest communication with your healthcare provider is crucial for optimal treatment outcomes.

Strategies to Avoid Missing a Dose

By following the recommended strategies to avoid missing doses, you can ensure consistent protection against blood clot-related complications. Stay proactive, informed, and prioritize your health when it comes to managing your Xarelto treatment.

To minimize the chances of missing a dose of Xarelto, consider the following strategies:

  1. Set Reminders: Utilize alarm clocks, smartphone reminders, or medication reminder apps to prompt you when it’s time to take your Xarelto dose.
  2. Pill Organizer: Use a pill organizer to pre-sort your medication doses for each day of the week. This can help you keep track of whether you have taken your daily dose.
  3. Travel Preparations: If you’re planning to travel, ensure you have enough Xarelto doses for the duration of your trip. Pack them securely in your carry-on luggage to avoid any potential issues with lost or delayed baggage.
  4. Refill Early: Stay ahead of your medication supply by refilling your Xarelto prescription before it runs out. This way, you won’t have to worry about running out of medication and missing doses.


It is essential to store Xarelto in a suitable environment to preserve its potency and quality. Here are some guidelines on how to store Xarelto properly:

  • Store at Room Temperature: Xarelto should be stored at room temperature, typically around 25 degrees Celsius (77 degrees Fahrenheit). Avoid exposing the medication to extreme temperatures, such as excessive heat or cold. Keep it away from direct sunlight, heaters, radiators, and refrigerators. Room temperature provides the optimal conditions for maintaining the stability of Xarelto.
  • Protect from Moisture: Moisture can degrade the quality of Xarelto and compromise its effectiveness. Therefore, it is crucial to store the medication in a dry place. Avoid storing Xarelto in the bathroom or any area prone to high humidity. Moisture can accelerate the degradation process and render the medication less effective.
  • Keep in Original Packaging: To ensure proper identification and to avoid confusion, it is recommended to store Xarelto in its original packaging. The original packaging contains essential information, including the medication name, dosage, and expiration date. Additionally, the packaging is designed to protect the medication from external factors that may compromise its quality.
  • Childproof Container: Store Xarelto in a childproof container to prevent accidental ingestion by children. The safety of your family and loved ones is of utmost importance, and storing Xarelto in a childproof container helps minimize the risk of any unwanted incidents.
  • Avoid Pill Splitters: Xarelto is available in different dosages to suit individual needs. However, it is crucial to avoid splitting or crushing the medication unless instructed by a healthcare professional. Maintaining the integrity of the tablet ensures the correct dosage and optimal efficacy.


IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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