Rivaroxaban: Difference between revisions
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==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 | *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]] | ||
==Pharmacology== | ==Pharmacology== | ||
Line 63: | Line 62: | ||
*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
- Bleeding, severe
- Epidural/spinal hematoma
- Thrombocytopenia
- Agranulocytosis
- Hypersensitivity reaction
- Stevens-Johnson syndrome
- Hepatitis
Common
- Bleeding
- Back pain
- Pruritus
- Elevated ALT
- Thrombocytopenia
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>