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Anticoagulant drug Xarelto (Rivaroxaban) for sale

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Discontinuation for Surgery and other Interventions

If anticoagulation must be discontinued to reduce the risk of bleeding with surgical or other procedures, Xarelto should be stopped at least 24 hours before the procedure to reduce the risk of bleeding. In deciding whether a procedure should be delayed until 24 hours after the last dose of Rivaroxaban (Xarelto), the increased risk of bleeding should be weighed against the urgency of intervention. This medication should be restarted after the surgical or other procedures as soon as adequate hemostasis has been established, noting that the time to onset of therapeutic effect is short. If oral medication cannot be taken during or after surgical intervention, consider administering a parenteral anticoagulant.

Missed Dose

If a dose of Xarelto is not taken at the scheduled time, administer the dose as soon as possible on the same day as follows:

  • For patients receiving 15 mg twice daily: The patient should take Rivaroxaban (Xarelto) tablets immediately to ensure intake of 30 mg this drug per day. In this particular instance, two 15 mg tablets may be taken at once. The patient should continue with the regular 15 mg twice daily intake as recommended on the following day.
  • For patients receiving 20 mg, 15 mg or 10 mg once daily: The patient should take the missed Xarelto dose immediately.

    Administration Options

    For patients who are unable to swallow whole tablets, 10 mg, 15 mg or 20 mg Xarelto (Rivaroxaban) tablets may be crushed and mixed with applesauce immediately prior to use and administered orally. After the administration of a crushed Xarelto 15 mg or 20 mg tablet, the dose should be immediately followed by food.

    Administration via nasogastric (NG) tube or gastric feeding tube

    After confirming gastric placement of the tube, 10 mg, 15 mg or 20 mg Xarelto (Rivaroxaban) tablets may be crushed and suspended in 50 mL of water and administered via an NG tube or gastric feeding tube. Since rivaroxaban absorption is dependent on the site of drug release, avoid administration of Xarelto distal to the stomach which can result in reduced absorption and thereby, reduced drug exposure. After the administration of a crushed this medicine 15 mg or 20 mg tablet, the dose should then be immediately followed by enteral feeding.

    Crushed 10 mg, 15 mg or 20 mg Rivaroxaban (Xarelto) tablets are stable in water and in applesauce for up to 4 hours. An in vitro compatibility study indicated that there is no adsorption of rivaroxaban from a water suspension of a crushed Xarelto tablet to PVC or silicone nasogastric (NG) tubing.

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