Can you drink coffee on Xarelto?

In this article:

• Xarelto and coffee
• Coffee and other blood thinners
• Best practices for Xarelto
• The bottom line

In this article

• Xarelto and coffee
• Coffee and other blood thinners
• Best practices for Xarelto
• The bottom line

Xarelto (rivaroxaban) is a powerful anticoagulant medication used to thin the blood. It works by blocking factor Xa, a key protein involved in the clotting process. You may be prescribed the medicine to treat deep vein thrombosis (a blood clot in a vein) or pulmonary embolism (blood clot in the lung). It’s also used to prevent harmful clots from forming in people with peripheral artery disease, coronary artery disease, or atrial fibrillation. 

If you’re taking Xarelto preventively, the dose is once or twice daily depending on the indication. As with any everyday treatment, you may wonder how it affects your usual routines, including one of the best parts of your day: coffee. A morning cup of joe is more than just a warm drink; for many of us, it’s a hallowed ritual. Fortunately, if you take Xarelto, rest assured that you do not have to forgo your regular caffeine fix. There are no known interactions between coffee and Xarelto. 

Save up to 80% on Xarelto with SingleCare

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.

Xarelto 2.5 mg (60 Tablet)

23666 - Hampton, VA

$70.68

i Price with signup

Get free coupon

$129.20

i Price with signup

Get free coupon

See Xarelto prices at all pharmacies

Can you drink coffee on Xarelto? 

Drink up! Generally, coffee is considered safe for people on Xarelto, though there are a few considerations to keep in mind. Coffee is a complex substance that has hundreds of chemical compounds. Though its main active ingredient is caffeine. A typical brewed cup of coffee contains around 96 milligrams of caffeine, whereas decaf coffee usually has less than 15 milligrams. 

“Since there are no direct interactions, moderate intake is generally fine,” says Elizabeth Rubin Ribak, MD, a board-certified healthcare provider based in Los Angeles, California. About two to three cups of coffee a day, or 200 to 300 milligrams of caffeine, would be considered moderate. 

If you exceed that amount of Java, it could exacerbate the following Xarelto side effects:

• Bleeding problems: Bleeding is a possible side effect of Xarelto, and there is some evidence that caffeine may be linked to certain types of hemorrhages. Coffee also increases stomach acid and may irritate the stomach lining,” Dr. Rubin Ribak says. “Xarelto increases the risk of gastrointestinal bleeding; thus, heavy coffee intake with Xarelto may increase stomach irritation.”
• Itchiness: People with caffeine sensitivity could experience itchiness after drinking coffee, which is also a side effect of Xarelto.
• Insomnia: Caffeine is a known stimulant that has been shown to interfere with sleep, and some Xarelto users find they experience insomnia while on the drug.

Alternatives to coffee, such as caffeine pills or tea, are also kosher as long as you stay in that same 200 to 300 mg daily range. For example, an 8-ounce cup of green tea contains about 29 milligrams of caffeine. 

Caffeine temporarily raises your blood pressure and heart rate. If you’re taking Xarelto to manage a heart disease affected by high blood pressure, be sure to discuss this effect with your healthcare provider and the caffeine limits that are safest for you. “If you notice heart palpitations, stomach irritation, or increased anxiety, you should cut back,” Dr. Rubin Ribak advises.

Does coffee interact with other blood thinners?

It is safe to drink coffee while taking many well-known blood thinners, such as Eliquis (apixaban), Plavix (clopidogrel), and even over-the-counter (OTC) Aspirin, which is sometimes used in combination with Xarelto for people with certain heart conditions. These medications pose similar risks as combining Xarelto and caffeine, mainly a slightly increased risk of bleeding.

Warfarin is a little riskier. It is metabolized by the same liver enzymes that process caffeine. When taken with excess caffeine, it can lengthen the time the drug stays in your body and increase your chances of unwanted bleeding. If you notice symptoms of excess bleeding, such as bruising, nosebleeds, or vomit that looks like coffee grounds, seek medical advice immediately.

Best practices for taking Xarelto

To get the most out of your medication and minimize the risk of side effects, try these tips:

• Take it at the same time every day: This helps to keep the medication’s levels consistent in your body and maximizes its effectiveness at preventing clots. For certain conditions, it’s best to take Xarelto with your evening meal to help increase absorption and reduce your risk of blood clots while you’re lying still at night.
• Take it with food: This helps make the medication more bioavailable or easy for your body to absorb.
• Make lifestyle changes: “Maintaining a healthy weight and activity level improves circulation and overall heart health, supporting Xarelto’s purpose,” advises Dr. Rubin Ribak.
• Share an updated list of medications with your healthcare team: This can help you avoid dangerous food, supplement, or drug interactions if you’re prescribed medication to treat other health conditions.

For example, it’s best not to drink alcohol or grapefruit juice when taking Xarelto, as the combination could lead to bleeding. Certain supplements, such as garlic, “vitamin E, omega-3 fatty acids, and St. John’s wort, can negatively interact with Xarelto, leading to potentially dangerous side effects,” says Michelle Routhenstein, MS, a registered cardiology dietitian at EntirelyNourished.com. 

Xarelto mainly interacts with drugs that can also increase bleeding risk, such as selective serotonin reuptake inhibitors (SSRIs), other blood thinners, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or diclofenac. 

The bottom line

Yes, you can enjoy a cup of coffee (or your favorite caffeinated drink) while you’re taking Xarelto. Keep in mind that for some people, coffee could increase the risk of bleeding or other Xarelto side effects, like stomach irritation. Discuss your coffee intake with a healthcare professional, as well as any other medicines or supplements you take or are considering taking.