- Prevention of venous thromboembolism in adults after hip or knee replacement:
- 10mg OD; started 6-10 hours after surgery as soon as hemostasis has been established
- Prophylaxis in major knee surgery:
- 20mg OD *12/7 started 6-10 hours after surgery as soon as hemostasis has been established
- Prophylaxis in major hip surgery
- 20mg OD *35/7 started 6-10 hours after surgery as soon as hemostasis has been established
- Thrombotic/cardiovascular event risk reduction:
- 5mg BD.
- For patients with PAD/CAD, give with aspirin 75-100mg OD
- To convert from warfarin, discontinue warfarin and start rivaroxaban when INR <3
- To convert from unfractionated heparin infusion, discontinue unfractionated heparin, then start rivaroxaban immediately.
- To convert from other anticoagulants, discontinue the anticoagulant, then start rivaroxaban 0-2h before next scheduled evening anticoagulant dose.
- Tablet:
- 10mg
- 15mg
- 20mg
- Consider holding treatment 24h before surgery or invasive procedure.
- Given with food.
Factor Xa inhibitor anticoagulant.
It is highly selective for factor Xa interrupting the intrinsic and extrinsic pathway of the blood coagulation cascade, inhibiting both thrombin formation and development of thrombi.
- Bleeding/hematoma
- Back pain
- Abdominal pain
- Pruritus
- Dizziness
- Anemia
- Hypersensitivity to components
- Active major bleeding
- Severe hepatic impairment
- CrCl <15
- Pregnancy
- Antiphospholipid syndrome
- Prosthetic heart valve
WARNING:
- There’s an increased risk of a thrombotic event or stroke when treatment is discontinued before completion of course.
- Consider switching to another anticoagulant if a change must be made for any reason.
- There is a risk of epidural/spinal hematoma after neuraxial anesthesia or spinal puncture in anticoagulated patients.
- Mifepristone
- Ketoconazole
- Itraconazole
- Voriconazole
- HIV protease inhibitors
- NSAIDs
- Warfarin
Drug Status
| Availability | Prescription only |
| Pregnancy | Contraindicated |
| Breastfeeding | Detected in breast milk. Not recommended |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Harteze | 10mg | Tablet | 28’s | Cosmos Ltd | Cosmos Ltd |
| Harteze | 15mg | Tablet | 28’s | Cosmos Ltd | Cosmos Ltd |
| Harteze | 20mg | Tablet | 28’s | Cosmos Ltd | Cosmos Ltd |
| Riva-Q | 10mg | Tablet | 10’s | Q Pharma DMCC | Cintana Healthcare |
| Riva-Q | 15mg | Tablet | 10’s | Q Pharma DMCC | Cintana Healthcare |
| Riva-Q | 20mg | Tablet | 10’s | Q Pharma DMCC | Cintana Healthcare |
| Rivaglax | 10mg | Tablet | 30’s | Galaxy Pharma | Galaxy Pharma |
| Rivaglax | 15mg | Tablet | 30’s | Galaxy Pharma | Galaxy Pharma |
| Rivaglax | 20mg | Tablet | 30’s | Galaxy Pharma | Galaxy Pharma |
| Rivarox | 10mg | Tablet | 20’s | Innocia Lifesciences | Wessex Pharma |
| Rivarox | 15mg | Tablet | 14’s | Innocia Lifesciences | Wessex Pharma |
| Rivarox | 20mg | Tablet | 14’s | Innocia Lifesciences | Wessex Pharma |
| Roxiclot | 10mg | Tablet | 30’s | Dawa Ltd | Dawa Ltd |
| Roxiclot | 15mg | Tablet | 30’s | Dawa Ltd | Dawa Ltd |
| Roxiclot | 20mg | Tablet | 30’s | Dawa Ltd | Dawa Ltd |
| Vaxato | 20mg | Tablet | 30’s | Liptis Pharma | Goodman Agencies |
| Vaxato | 10mg | Tablet | 10’s | Liptis Pharma | Goodman Agencies |
| Vaxato | 15mg | Tablet | 10’s | Liptis Pharma | Goodman Agencies |
| Xarelto | 2.5mg | Tablet | 28’s | Bayer Schering | Bayer Schering |
| Xarelto | 10mg | Tablet | 10’s | Bayer Schering | Bayer Schering |
| Xarelto | 15mg | Tablet | 14’s | Bayer Schering | Bayer Schering |
| Xarelto | 20mg | Tablet | 14’s | Bayer Schering | Bayer Schering |