Rivaroxaban is a highly selective direct coagulation factor Xa inhibitor that exerts antithrombotic effects by inhibiting free and bound coagulation factor Xa and prothrombin activity, blocking the coagulation cascade reaction.

1、 Drug name

1. Common name: Rivaroxaban

2. Product Name: XARELTO ®。

2、 Indications

1. Adult patients:

Non valvular atrial fibrillation: reduces the risk of stroke and systemic embolism.

Deep vein thrombosis (DVT) and/or pulmonary embolism (PE): treatment and reduction of recurrence risk.

Orthopedic surgery: prevention of DVT after hip or knee replacement surgery.

Acute internal medicine diseases: prevention of venous thromboembolism (VTE) in acute internal medicine hospitalized patients without high-risk bleeding diseases.

Coronary heart disease (CAD) and peripheral arterial disease (PAD): In specific cases, aspirin is used in combination to reduce the risk of major cardiovascular events (death/myocardial infarction/stroke/acute limb ischemia, etc.).

2. Child patients:

Newborns to under 18 years old: Treat VTE (venous thromboembolism) and reduce the risk of recurrence (applicable to specific conditions, such as having received at least 5 days of initial treatment).

2 years old and above: Thrombosis prevention for children with congenital heart disease who have undergone Fontan surgery.

3、 Specifications and characteristics

Tablets:

15 milligrams: round, red.

20mg: Triangular, deep red.

4、 Usage and dosage

1. Adult usage and dosage:

Non valvular atrial fibrillation: usually 15 or 20 milligrams, taken once a day with dinner (to reduce bleeding risk with food).

Treatment for DVT/PE: Take 15mg twice daily with meals for 21 days, then switch to 20mg once daily with meals.

Prevention of DVT after hip/knee replacement surgery: 10mg once daily, starting 6-10 hours before surgery, lasting 5-6 weeks (hip) or 12 days (knee).

Coronary heart disease/peripheral arterial disease: 2.5 milligrams twice daily, combined with aspirin once daily (75-100 milligrams).

Prevention of VTE: 10mg once daily for acute internal medicine inpatients, starting from the hospital and continuing until discharge, is recommended to last for a total of 31 to 39 days.

2. Usage and dosage for children:

Treatment and reduction of VTE recurrence risk: The dosage should be precisely adjusted according to body weight, and the specific dosage should strictly follow the doctor's advice.

Prevention of thrombosis after Fontan surgery: The dosage should be precisely adjusted according to body weight, please follow the doctor's advice for details.

5、 Dose adjustment

1. Kidney injury patients:

Non valvular atrial fibrillation: When the glomerular filtration rate is ≤ 50 milliliters per minute, it should be reduced to 15 milligrams once daily.

DVT/PE therapy: Patients with glomerular filtration rate<15 mL/min should avoid using it.

Coronary heart disease/peripheral arterial disease treatment: Individualized adjustments need to be made based on renal function status.

6、 Medication precautions

1. Medication time:

Non valvular atrial fibrillation: taken with dinner.

Treatment of DVT/PE: The timing of medication and eating should be consistent.

Coronary heart disease/peripheral arterial disease: can be taken with or without food.

Please follow the doctor's advice for the specific medication time.

2. Leakage handling:

Adult patients:

Take 15mg twice a day: immediately supplement. Two doses can also be taken together on the same day.

Take 20mg, 15mg, or 10mg once daily: immediately supplement. Do not take double the dose on the same day to make up for it.

3. Post vomiting treatment:

If vomiting occurs within 30 minutes, the full dose should be taken again.

If vomiting occurs more than 30 minutes later, the medication should not be re administered, but the next dose should be taken according to the original schedule.

If vomiting occurs repeatedly, contact a doctor immediately.

4. Other precautions:

It is not advisable to stop medication at will: unless the medication is stopped due to pathological bleeding or completion of the treatment course, other anticoagulant drugs should be switched under the guidance of a doctor.

Before surgery, it is necessary to inform the doctor that the patient must inform all doctors and dentists that they are taking rivaroxaban and stop using it for at least 24 hours to reduce the risk of bleeding before restarting at an appropriate time.

7、 Medication for special populations

1. Pregnant women: Use only when the potential benefits outweigh the potential risks to the mother and fetus.

2. Breastfeeding women: Consideration should be given to the clinical needs of the mother and potential risks to the baby (such as minimal secretion of drugs into breast milk).

3. Elderly people: The incidence of events increases with age.

8、 Adverse reactions

1. The most common adverse reaction: bleeding is the most common adverse reaction in adult patients (incidence>5%). The most common adverse reactions (incidence>10%) in pediatric patients include bleeding, coughing, vomiting, and gastroenteritis.

2. Please closely monitor and immediately report any signs of abnormal bleeding, such as nosebleeds, gum bleeding, excessive menstrual flow, black stool or hematuria, unexplained headaches or dizziness, etc.

9、 Contraindications

Rivaroxaban is prohibited from being used for:

1. Patients with active pathological bleeding.

2. Patients with severe allergic reactions (such as allergic reactions) to rivaroxaban.

10、 Drug interactions

1. Avoid combination therapy with certain medications (such as ketoconazole, ritonavir, clarithromycin) to prevent increased risk of bleeding.

2. Avoid co administration with certain medications (such as carbamazepine, phenytoin, rifampicin, St. John's wort) to prevent an increased risk of blood clots.

3. Combining with anticoagulants or nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bleeding.

11、 Storage method

Store the tablets at room temperature (20 ° C to 25 ° C, 68 ° F to 77 ° F).

Rivaroxabaninformation