Has your doctor prescribed you a blood thinner? It could be a medicine called Rivaroxaban. Did you feel a little scared when you heard this name? Don't think so. This is a very important medicine that is often given to protect us from dangerous conditions like heart disease and stroke. So today, let's talk about this medicine called Rivaroxaban, how to use it, what things to be careful about, what side effects, everything in a very simple way that you can understand.
Simply put, what is Rivaroxaban?
Rivaroxaban is an anticoagulant, or as we commonly call it, a "blood thinner." However, it doesn't actually thin the blood, it prevents the formation of blood clots in the veins of our body. These blood clots are very dangerous. Because if they travel along the veins and get stuck in the brain, heart, or lungs, they can cause serious conditions like stroke and heart attack.
This medicine is mainly used for the following conditions:
- Prevent blood clots or treat existing blood clots: Especially for blood clots that form in the legs (Deep Vein Thrombosis - DVT) or lungs (Pulmonary Embolism - PE).
- Reduce the risk of stroke in people with Atrial Fibrillation (AFib): AFib is an irregular heartbeat that increases the risk of blood clots forming in the heart and traveling to the brain.
- Reduce the risk of heart attack or stroke for those with coronary artery disease or peripheral artery disease.
- Prevent blood clots after hip or knee replacement surgery.
In Sri Lanka, this drug is most commonly known by the brand name Xarelto . This may be the name your doctor prescribed for you.
Things you need to tell your doctor before taking this medicine
Before starting rivaroxaban, it is important for your doctor to know your complete health history. This is because this medication can interact with certain medical conditions. So if you have any of the following conditions, be sure to tell your doctor.
| Your situation | Why is it important to inform the doctor? |
|---|---|
| If you have bleeding disorders or problems | This medicine increases the risk of bleeding, so it can be very dangerous if you already have such a problem. |
| If you have a prosthetic heart valve | This medication is not recommended for patients with these types of valves. |
| If you have liver or kidney disease | Since medications are eliminated from the body through these organs, if their function is impaired, the dosage of the medication may need to be adjusted. |
| If you are scheduled to undergo surgery or an epidural in the future | Because bleeding can be difficult to control during surgery, your doctor will advise you to stop taking the medication a few days before surgery. |
| If you have a condition called (Antiphospholipid syndrome - APS) | Rivaroxaban has been reported to increase the risk of blood clots in people with this condition. |
| If you are pregnant or trying to get pregnant | During pregnancy, this medication can pose a risk of bleeding for both the mother and the baby. Therefore, you should talk to your doctor to decide what is best for you. |
| If you are a breastfeeding mother | You should discuss with your doctor whether the medication can pass to the baby through breast milk. |
| If you have allergies to this medicine or anything else | It is very important to inform your doctor if you have any allergies. |
How exactly should I use this medicine?
This is the most important part. To get the most out of this medicine, it is essential to take it exactly as prescribed by your doctor.
- Don't rush, don't miss doses: Take your prescribed dose exactly when your doctor tells you to. Skipping doses or stopping your medication on your own can increase your risk of blood clots or stroke. Keep taking your medication until your doctor tells you to stop.
- Should you take it with or without food?: This depends on the reason you were prescribed the medication.
- After hip or knee surgery: Can be taken with or without food.
- For Atrial Fibrillation (AFib): Take every evening with a meal.
- As a treatment for blood clots: Take at the same time every day, with food.
- For heart disease or arterial disease: Take at the same time every day, with or without food.
- If you have trouble swallowing the pill: If you have trouble swallowing the pill, you can crush it up and mix it with a little applesauce. You should eat some more food after taking it. However, it is best to consult your doctor before doing this.
Important: This medicine is for you only. Do not give this medicine to someone else just because they have the same symptoms as you. It can be dangerous.
What to do if you overdose?
If you have even the slightest suspicion that you have taken more medicine than you think, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice. This is something that should not be delayed.
What if I miss a dose of medication?
This is something that happens to many people. Don't worry. Do this.
- If you take one dose a day: Take the missed dose as soon as you remember. However, if it is almost time for your next dose, meaning it is within a few hours, skip the missed dose and take the next dose at the scheduled time. Never take a double dose.
- If you are taking it twice a day to treat blood clots: Take the missed dose as soon as you remember. In this case, you can take both pills at once if necessary. Then take it twice a day as usual from that day on.
- If you are taking it twice a day for heart disease or arterial disease: Do not take the missed dose. Skip it and take the next dose at the scheduled time. Do not take a double dose to make up for a forgotten dose.
What other medications may interact with this medicine?
Rivaroxaban is a medication that can interact with other medications. Therefore, you should tell your doctor about all other medications you are taking, including prescription medications, over-the-counter pain relievers, vitamins, herbal remedies, and even herbal supplements.
Below are some of the main medications that may interact with Rivaroxaban.
| Type of medicine | Examples |
|---|---|
| Other blood thinners | Warfarin, Apixaban, Dabigatran, Enoxaparin |
| Painkillers (NSAIDs) and aspirin | Aspirin, Ibuprofen, Naproxen, Diclofenac |
| Some fungicides | Ketoconazole, Itraconazole |
| Some antibiotics | Erythromycin, Clarithromycin |
| Some medicines for migraines | Carbamazepine, Phenytoin |
| Some medications for depression | SSRIs (e.g. Fluoxetine, Sertraline) and SNRIs (e.g. Venlafaxine, Duloxetine) |
| Herbal products | St. John's wort |
This list is not complete. So you takeThe safest thing to do is to tell your doctor about all your medications.
Things to be careful about when taking medicine
You need to think especially about your safety while taking this medicine.
- Be careful of falls and injuries: Even a small cut can cause a lot of bleeding while taking this medicine. So, avoid sports and activities that may cause you to fall. Imagine that you cut your hand a little while chopping vegetables in the kitchen. Usually, applying a little pressure will stop the bleeding. However, when taking this medicine, it may take a little longer for the bleeding to stop.
- Be careful when using sharp objects: Think twice before using things like knives and scissors. If you are shaving, it is safer to use an electric razor instead of a regular razor.
- Be careful when brushing your teeth: Do not brush vigorously when brushing your teeth. Use a soft toothbrush. Even when flossing, be careful not to injure your gums.
- Be aware of unusual bleeding: If you notice things like your body turning blue for no reason or bleeding from small cuts that won't stop, tell your doctor.
- Wear a medical ID: Wearing a medical ID bracelet or carrying a card stating that you are taking blood thinners could help save your life in an emergency.
What side effects might I experience?
Like any medicine, Rivaroxaban can have side effects. However, not everyone gets them. The main side effect and one we should be most concerned about is excessive bleeding.
If you experience the following symptoms, do not delay and call your doctor or go to a hospital immediately.
| Serious side effects that require immediate medical attention | |
|---|---|
| Allergic Reaction | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Unusual bleeding | Black or tarry stools, vomiting blood that looks like coffee grounds, red or dark brown urine, small red or purple spots on the skin, turning blue for no reason, or bleeding from a wound that won't stop. |
| Symptoms of a brain hemorrhage | Severe headache, stiff neck, confusion, dizziness, vision changes, numbness or weakness in the face, arm or leg, difficulty speaking or walking. |
| For women | Excessive bleeding during menstruation. |
If you experience any other unusual symptoms not mentioned on this list, talk to your doctor about them as well.
Take-Home Message
- Rivaroxaban is a very important medication that prevents blood clots. Take it exactly as your doctor tells you, at the time and in the dose prescribed.
- Do not stop taking the medication or change the dosage on your own. Stopping without your doctor's advice can cause serious complications, such as a stroke.
- There is a high risk of bleeding when taking this medication, so be very careful about falls and injuries.
- Tell your doctor about all other medications you take, and if you are going to have surgery.
- If you notice any signs of unusual bleeding, such as black stools, vomiting blood, or turning blue, seek medical advice immediately.
- If you have any questions or doubts about this medicine, ask your doctor. Don't be afraid of anything.
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