Rivaroxaban (Xarelto) — a practical guide you can use
Rivaroxaban is a direct oral anticoagulant (DOAC) many doctors choose to prevent clots. It blocks factor Xa, which helps stop blood from forming dangerous clots in conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism (PE). This page gives straightforward dosing rules, safety tips, and everyday advice so you know what to watch for.
When and how it's used
Common uses and typical dosing you’ll see: for non-valvular atrial fibrillation (stroke prevention) the usual dose is 20 mg once daily with the evening meal. If kidney function is reduced (creatinine clearance 15–50 mL/min) many clinicians use 15 mg once daily. For treating DVT or PE: start with 15 mg twice daily with food for 21 days, then switch to 20 mg once daily with food. For short-term prevention after hip or knee replacement the dose is usually 10 mg once daily.
Take rivaroxaban with food when you use the 15 mg or 20 mg doses — food boosts absorption and helps the drug work consistently. If you miss a dose: for twice-daily 15 mg take the missed pill immediately and then take the next dose at the usual time (so you get two doses in 12 hours). For once-daily doses, take a missed dose within 12 hours; if it’s later, skip it and resume tomorrow. Don’t double up outside those windows.
Safety tips and interactions
Bleeding is the main risk. Watch for unusual bruising, bloody stools, pink urine, or long nosebleeds. If serious bleeding occurs, call emergency services. Andexanet alfa is the specific reversal agent in many hospitals; if it’s not available, teams may use prothrombin complex concentrate (PCC).
Rivaroxaban interacts with drugs that affect CYP3A4 and P-gp. Strong dual inhibitors (for example some antifungals and antivirals) can increase bleeding risk and are often avoided together. Combining rivaroxaban with other blood thinners or regular NSAIDs raises bleeding risk too — always tell providers what you take.
Kidney and liver function matter. If your kidney function is poor, dosing may change or the drug may be avoided. Severe liver disease that affects clotting is usually a contraindication. Pregnant people generally aren’t given rivaroxaban; talk to your clinician about safer options.
Before surgery or dental work, tell the team you’re on rivaroxaban. Many procedures need the drug stopped 24–48 hours before, longer if bleeding risk or kidney function is low. Never stop anticoagulation without guidance — sudden interruption can increase clot risk.
Questions for your clinician: do I need a dose change for my kidneys? Can I take my other meds with rivaroxaban? What should I do if I bleed? These simple questions help you stay safe. If you’re buying meds online, use only reputable pharmacies and always check a prescription requirement — your health depends on it.
