Difference between revisions of "Rivaroxaban"

(Adult Dosing)
Line 40: Line 40:
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
*Bleeding, severe
+
*[[Anticoagulant reversal for life-threatening bleeds|Bleeding, severe]]
*Epidural/spinal hematoma
+
*Epidural/[[spinal hematoma]]
*Thrombocytopenia
+
*[[Thrombocytopenia]]
 
*Agranulocytosis
 
*Agranulocytosis
*Hypersensitivity rxn
+
*Hypersensitivity reaction
*Stevens-Johnson syndrome
+
*[[Stevens-Johnson syndrome]]
*Hepatitis
+
*[[Hepatitis]]
 
===Common===
 
===Common===
 
*Bleeding
 
*Bleeding
*Back pain
+
*[[Back pain]]
*Pruritus
+
*[[Pruritus]]
 
*Elevated ALT  
 
*Elevated ALT  
*Thrombocytopenia
+
*[[Thrombocytopenia]]
*Decreased platelets
 
  
 
==Pharmacology==
 
==Pharmacology==
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*Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of factor Xa in both the intrinsic and extrinsic coagulation pathways  
 
*Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of factor Xa in both the intrinsic and extrinsic coagulation pathways  
  
 +
==See Also==
 +
*[[Anticoagulant reversal for life-threatening bleeds]]
  
 
==References==
 
==References==
 
<UpToDate, Epocrates>
 
<UpToDate, Epocrates>
 
[[Category:Pharmacology]]
 
[[Category:Pharmacology]]

Revision as of 13:36, 3 April 2016

Administration

  • Type: Anticoagulant, Factor Xa Inhibitor
  • Dosage Forms: 10, 15, 20
  • Routes of Administration:
  • Common Trade Names: Xarelto

Adult Dosing

  • Thromboembolism/stroke prophylaxis: 20 mg PO qd
  • DVT Prophylaxis: 10 mg PO qd x35 days; Start: 6-10h post-op once hemostasis established
  • DVT/PE Prophylaxis, recurrent: 20 mg PO qd
  • DVT/PE Treatment: 20 mg PO qd

Special Populations

  • Pregnancy Risk Factor: C

Renal Dosing

  • Thromboembolism/stroke prophylaxis
    • CrCl 15-50: 15 mg qd; CrCl <15: avoid use
  • DVT prophylaxis
    • CrCl 30-50: caution advised; CrCl <30: avoid use
  • DVT/PE prophylaxis, recurrent
    • CrCl <30: avoid use
  • DVT/PE tx
    • CrCl <30: avoid use

Hepatic Dosing

  • Avoid Use In:
    • Child-Pugh Class B or C
    • Coagulopathy-assoc. hepatic disease

Contraindications

  • Active major bleeding
  • Hepatic impairment, Child-Pugh Class B or C
  • Coagulopathy-assoc. hepatic disease
  • CrCl <30 (DVT prophylaxis, recurrent DVT/PE prophylaxis, DVT/PE tx use)
  • CrCl <15 (thromboembolism/stroke prophylaxis use)
  • Acute PE with hemodynamic instability
  • Acute PE requiring thrombolysis or pulmonary embolectomy

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 5-9 hours
  • Metabolism: CYP450
  • Excretion: 66% Urine, 28% Feces

Mechanism of Action

  • Inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of factor Xa in both the intrinsic and extrinsic coagulation pathways

See Also

References

<UpToDate, Epocrates>