VTE prevention in hip or knee replacement surgery 10 mg once daily. Duration of treatment: Depends on the type of major orthopaedic surgery. Initial dose to be taken 6-10 hr after surgery when hemostasis is established. Prevention of stroke & systemic embolism 20 mg once daily. Severe (CrCl 15-29 mL/min) or moderate (30-49 mL/min) renal impairment 15 mg once daily. Initial treatment of acute DVT or PE 15 mg bd for 1st 3 wk followed by 20 mg once daily thereafter.
View Xarelto overdosage for action to be taken in the event of an overdose.
Administration
10-mg tab: May be taken with or without food.. 15- & 20-mg tab: Should be taken with food.. For patients unable to swallow, tab may be crushed & mixed w/ water or apple puree immediately prior to taking. Crushed tab may also be mixed w/ small amount of water & administered via gastric tube. The tube should be flushed w/ water after administration.
Contraindications
Hypersensitivity. Clinically significant active bleeding; lesion or condition at significant risk of major bleeding. Concomitant treatment w/ other anticoagulant agent except switching therapy or use of UFH to maintain open central venous or arterial catheter. Hepatic disease associated w/ coagulopathy & clinically relevant bleeding risk including cirrhotic patients w/ Child-Pugh B & C. Pregnancy & lactation.
Discontinue use if severe haemorrhage occurs. Serious skin reactions eg, SJS/TEN. Congenital or acquired bleeding disorders, uncontrolled severe arterial HTN; current or recent GI ulceration, other GI disease w/o active ulceration potentially leading to bleeding complications; recent intracranial or intracerebral hemorrhage; intraspinal or intracerebral vascular abnormalities; recent brain, spinal or ophth surgery; vascular retinopathy, bronchiectasis or history of pulmonary bleeding; epidural/spinal anesth or puncture. Patients w/ non-valvular atrial fibrillation who undergo percutaneous coronary intervention w/ stent placement; w/ prosthetic heart valves; w/ haemodynamically unstable PE or who require thrombolysis or pulmonary embolectomy; pre- & post-invasive procedures & surgical interventions. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Not recommended in concomitant use w/ potent azole-antimycotics, HIV PIs, other antiplatelets. May affect ability to drive & use machines. Renal impairment. Women of childbearing potential should avoid pregnancy during treatment. Elderly.
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