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Rivaroxaban

Rivaroxaban

Rivaroxaban is an anticoagulant medication that belongs to the class of direct oral anticoagulants (DOACs). It works by inhibiting Factor Xa, a key component in the blood clotting cascade. Rivaroxaban is an oral anticoagulant used to prevent and treat conditions associated with abnormal blood clotting. It is a selective inhibitor of Factor Xa, disrupting the coagulation process.

Indications

-Prevention of stroke and systemic embolism in non-valvular atrial fibrillation. -Treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). -Prevention of recurrent DVT and PE. -Prophylaxis of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery. -Rivaroxaban is used to reduce the risk of stroke and blood clots in people with atrial fibrillation, not caused by a heart valve problem. Rivaroxaban is also used to treat deep vein thrombosis and pulmonary embolism, and to help reduce the risk of these conditions occurring again, and to reduce the risk of forming a blood clot in the legs and lungs of people who have just had knee or hip replacement surgery.


Dosage

-Dosage may vary depending on the specific indication. It is crucial to follow the prescribing physician's recommendations. Oral; 10mg, 15mg,20mg DVT Prophylaxis (Orthopedic Surgery) Indicated for prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) in patients undergoing knee or hip replacement surgery Knee replacement: 10 mg orally once/day for 12 days; may take with or without food. Hip replacement: 10 mg orally once/day for 35 days; may take with or without food Administer initial dose at least 6-10 hours after surgery once hemostasis has been established. Nonvalvular Atrial Fibrillation Indicated to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation 20 mg/day orally with the evening meal Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE) Treatment Indicated for the treatment of DVT and PE 15 mg orally every 12 hours for 21 days with food, THEN 20 mg orally once/day for 6 months Reduce risk for recurrent DVT or PE Indicated to reduce the risk of recurrence of DVT and PE following initial 6 months treatment for DVT and/or PE 20 g orally once/day following initial 6 months of treatment for DVT and/or PE


Contra-Indications

-Hypersensitivity to rivaroxaban. -Active bleeding. -Severe liver disease. -Pregnancy and breastfeeding. -Stop rivaroxaban at least 24 hours before the procedure, Restart rivaroxaban after surgery/procedure as soon as adequate hemostasis is established


Special Precautions

-Renal impairment: Adjust dosage in patients with renal dysfunction. -Liver impairment: Caution in patients with mild to moderate hepatic impairment. -Risk of bleeding: Monitor patients for signs of bleeding. Paediatric: Data not sufficient Pregnancy: Use rivaroxaban with caution during pregnancy if the benefits outweigh the risks. Lactation: It is unknown whether rivaroxaban is distributed in human breast milk; it is not recommended for use while breastfeeding. Elderly: Data not sufficient


Side Effects

-Common side effects may include bleeding, easy bruising, and gastrointestinal discomfort. Serious but rare side effects include severe bleeding and allergic reactions. -Abdominal pain, back pain, bleeding, blister, blood in urine, constipation, diarrhea, dizziness, fainting, fatigue, fever headache, indigestion, itching, muscle pain, muscle spasm, sore throat, UTI, wound secretion, vomiting, Agranulocytosis, Dry mouth, Fatal bleeding, Heavy or prolonged menstrual periods ,Hemorrhage, Hepatitis ,Hives, Increased amylase, Increased BUN, Low blood platelets (thrombocytopenia), Low blood pressure (hypotension), Painful or difficult urination, Retroperitoneal bleeding, Stevens-Johnson syndrome, Weakness of one side of the body, Yellowing skin and eyes (jaundice)


Drug Interactions

-Strong CYP3A4 and P-glycoprotein inhibitors (e.g., ketoconazole, ritonavir) may increase rivaroxaban levels. -Strong CYP3A4 and P-glycoprotein inducers (e.g., rifampin) may decrease rivaroxaban levels. -Defibrotide, prothrombin complex concentrate, human, apixaban, clarithromycin, cobicistat, conivaptan, edoxaban, factor X, human, idelalisib, indinavir, ketoconazole, ritonavir


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