Rivaroxaban is a blood-thinning medicine used to treat or prevent blood clots in the veins of your legs or lungs and prevents it from re-occurring.
This medicine may also be used to prevent blood clots after a hip or knee replacement operation and to prevent stroke and heart attack in adults with heart disease.
Rivaroxaban may be used to treat other conditions as decided by your doctor.
Take Rivaroxaban exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
Ask your doctor or pharmacist whether you should take this medicine with or without food. Food intake instructions for different doses of this medicine may vary. Rivaroxaban 2.5 mg and 10 mg tablets can be taken with or without food. Higher doses of this medicine (e.g. 15 and 20 mg) should be taken with food. Try to take it at the same time each day.
Rivaroxaban is available as a tablet and as granules for oral suspension.
If you have difficulty swallowing the tablet(s), you may crush the tablet(s) and mix it with water or apple puree. Stir and drink immediately.
If you are taking an oral suspension, shake the bottle well before you take the medicine to ensure that the liquid is evenly mixed. Use the measuring spoon or cup provided to measure your dose.
Rivaroxaban must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
If you are taking Rivaroxaban 15 mg tablet twice daily, you may take 2 tablets at the same time then return to your normal dosing schedule.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- excessive bleeding
- risk of serious bleeding e.g. stomach ulcer, brain or spinal injury
- recent surgery e.g. brain, spinal column, or eye operation
- liver disease that may lead to increased risk of bleeding
as Rivaroxaban may not be suitable for you.
If you are going for a surgical procedure where you have to undergo anaesthesia (medicines to block pain and sensation) administered in the spine, inform your doctor that you are taking Rivaroxaban.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Rivaroxaban, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Rivaroxaban.
Do not take this medicine if you are breastfeeding.
Do not take Rivaroxaban with medicines used to treat fungal infection, HIV infection, and blood clots. Please see the section "Can I take this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- very high blood pressure, not controlled by medication
- vascular retinopathy (problem with the blood vessels in the back of the eyes)
- stomach problems e.g. stomach or oesophagus inflammation
- lung disease e.g. previous bleeding from the lung, widened and pus-filled bronchi
- history of stroke
- kidney disease
Be sure to check with your doctor or pharmacist before giving Rivaroxaban to a child or the elderly. Children and elderly people may be more sensitive to the side effects.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and kidney function, complete blood count, bleeding time) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of signs of bleeding or blood loss may also be needed.
Rivaroxaban may cause dizziness or fainting (temporary loss of consciousness). If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: bleeding, headache, fever, nausea, diarrhoea, vomiting, tiredness, pain in hands or feet, paleness, and allergic reaction (e.g. rash, itching).
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs of long or excessive bleeding e.g. unusual weakness, tiredness, paleness, dizziness, headache, unexplained swelling, breathlessness, chest pain
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- pass out bloody or black as tar stools and vomiting blood or ground coffee-like material
- unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own)
- pink, red or dark brown urine
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Rivaroxaban with the following medicines:
- medicines for fungal infection e.g. ketoconazole, itraconazole, fluconazole
- medicines for HIV infection e.g. ritonavir
- other blood-thinning medicines e.g. warfarin, enoxaparin, dalteparin, fondaparinux, dabigatran, apixaban, heparin
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat TB (infection known as tuberculosis) e.g. rifampicin
- medicines for high blood pressure and heart disease e.g. diltiazem, verapamil
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Rivaroxaban.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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