{"id":45301,"date":"2021-11-01T09:23:55","date_gmt":"2021-11-01T13:23:55","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=45301"},"modified":"2025-10-16T14:54:55","modified_gmt":"2025-10-16T18:54:55","slug":"xarelto-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/xarelto-side-effects\/","title":{"rendered":"Xarelto side effects and how to avoid them"},"content":{"rendered":"<p><a href=\"#common-side-effects\">Xarelto side effects<\/a> | <a href=\"#serious-side-effects\">Serious side effects<\/a> | <a href=\"#bleeding\">Bleeding<\/a> | <a href=\"#reversal\">Reversal<\/a> | <a href=\"#how-long-do-side-effects-last\">How long do side effects last?<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a> <a href=\"#resources\">Resources<\/a><\/p>\n<p><span style=\"font-weight: 400;\">Xarelto is a brand-name prescription oral <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticoagulants\"><span style=\"font-weight: 400;\">anticoagulant<\/span><\/a><span style=\"font-weight: 400;\"> used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). It can also be used to prevent <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/deep-vein-thrombosis-treatment-and-medications\"><span style=\"font-weight: 400;\">deep vein thrombosis<\/span><\/a><span style=\"font-weight: 400;\"> in people at risk for blood clots, including people who are hospitalized with an illness and those who are undergoing hip replacement surgery or knee replacement surgery. Xarelto is also FDA-approved to reduce the risk of stroke and other problems from blood clots in people diagnosed with nonvalvular <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/atrial-fibrillation-treatment-and-medications\"><span style=\"font-weight: 400;\">atrial fibrillation<\/span><\/a><span style=\"font-weight: 400;\">, coronary artery disease, or peripheral artery disease.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Xarelto contains the active ingredient rivaroxaban and works to slow the formation of blood clots. It is classified as a factor Xa inhibitor that works by blocking one of the proteins, called factor Xa (\u201c10-A\u201d), involved in the blood clotting process. Oral anticoagulants like Xarelto are effective for treating and preventing blood clots, but they have some side effects to be aware of.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">RELATED: <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/xarelto\/what-is\"><span style=\"font-weight: 400;\">What is Xarelto?<\/span><\/a><span style=\"font-weight: 400;\"> | <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/xarelto\"><span style=\"font-weight: 400;\">Get Xarelto discounts<\/span><\/a><\/p>\n<h2 id=\"common-side-effects\">Common side effects of Xarelto<\/h2>\n<p><span style=\"font-weight: 400;\">The most common <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/610205\/Xarelto\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">side effects<\/span><\/a><span style=\"font-weight: 400;\"> of Xarelto are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Back pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Itching<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tiredness<\/span><\/li>\n<\/ul>\n<h2 id=\"serious-side-effects\">Serious side effects of Xarelto<\/h2>\n<p><span style=\"font-weight: 400;\">The most <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/610205\/Xarelto\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">serious side effects<\/span><\/a><span style=\"font-weight: 400;\"> experienced with Xarelto are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding around the spinal cord (epidural or spinal hematoma)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding in the eye (ocular hemorrhage)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low platelet counts (thrombocytopenia)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low numbers of certain types of white blood cells (agranulocytosis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe allergic reactions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver problems, including hepatitis<\/span><\/li>\n<\/ul>\n<h3 id=\"bleeding\">Xarelto and bleeding<\/h3>\n<p><span style=\"font-weight: 400;\">To prevent dangerous blood clots from forming in the blood vessels or heart, Xarelto blocks the blood-clotting process. However, Xarelto\u2019s effects can make people vulnerable to uncontrolled bleeding. As a blood thinner, Xarelto can cause minor bleeding events, such as prolonged bleeding from a cut, bruise, or nosebleed. In some cases, Xarelto can cause major bleeding events that could be life-threatening and require emergency hospitalization. Some types of bleeding episodes can go unnoticed because they happen inside the body, such as in the intestines.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serious bleeding events are rare with Xarelto, and there is a lower risk of major bleeding with Xarelto versus other anticoagulants like enoxaparin and warfarin. In clinical studies, <\/span><a href=\"https:\/\/www.xarelto-us.com\/what-is-xarelto\/xarelto-bleeding-risks\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">1%<\/span><\/a><span style=\"font-weight: 400;\"> of people taking Xarelto for DVT or PE treatment experienced a major bleeding episode. It\u2019s important to call a healthcare provider or get emergency medical help at any sign of a bleeding problem, even if it seems minor. An antidote called Andexxa (andexanet alfa) is available to help treat life-threatening bleeding problems caused by Xarelto. Once administered, the antidote quickly reverses Xarelto\u2019s effects on blood-clotting.<\/span><\/p>\n<h3 id=\"reversal\">Xarelto reversal<\/h3>\n<p><span style=\"font-weight: 400;\">The Xarelto antidote can quickly reverse Xarelto\u2019s effects on blood clotting in cases of prolonged bleeding and internal bleeding. It can also be used to reverse the effects of Xarelto to prepare a person for emergency surgical procedures, dental procedures, spinal surgery, spinal puncture, epidural procedures, or the removal of a spinal catheter. If needed, Andexxa will be administered by a healthcare provider. Andexxa works <\/span><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1510991\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">by blocking the ability of rivaroxaban<\/span><\/a><span style=\"font-weight: 400;\"> to bind to factor Xa, restoring the body\u2019s natural ability to form blood clots. Andexxa is also approved to reverse the effects of another factor Xa inhibitor called apixaban (Eliquis).\u00a0<\/span><\/p>\n<h2 id=\"how-long-do-side-effects-last\">How long do side effects last?<\/h2>\n<p><span style=\"font-weight: 400;\">The side effects of Xarelto are generally mild and temporary. Side effects may go away within a few days to a couple weeks after taking the drug consistently. If side effects are particularly bothersome or severe, you should seek medical advice from your healthcare provider.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The terminal half-life of rivaroxaban is <\/span><a href=\"https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/9875401\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">five to nine hours<\/span><\/a><span style=\"font-weight: 400;\"> in healthy people. That\u2019s the time it takes for the body to eliminate half a dose of Xarelto, but this may take longer in elderly patients or people with liver disease or kidney problems. The effects of rivaroxaban on blood clotting will start to fade after 24 hours.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serious adverse events, such as allergic reactions and severe bleeding episodes, require immediate medical attention. Severe bleeding in certain parts of the body, such as the eyes or brain, could have lifelong complications.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, stopping a blood-thinner like Xarelto increases the risk of blood clots, so this medicine should never be discontinued unless you\u2019re instructed to do so by your healthcare provider.<\/span><\/p>\n<p><strong>RELATED: <a href=\"https:\/\/www.singlecare.com\/blog\/blood-thinner-before-surgery\/\">Is it safe to stop blood thinners before surgery?<\/a><\/strong><\/p>\n<h2 id=\"warnings\">Xarelto contraindications &amp; warnings<\/h2>\n<p><span style=\"font-weight: 400;\">Anticoagulants carry a risk of bleeding and serious injury. This risk can go up in people with certain medical conditions, such as liver problems, kidney problems, and antiphospholipid syndrome (APS). It\u2019s important to familiarize yourself with Xarelto warnings and precautions before taking Xarelto.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The U.S. Food and Drug Administration (FDA) does not consider rivaroxaban to be a drug that has a risk of physical dependence, misuse, or abuse. While Xarelto does not cause withdrawal symptoms, the risk for blood clots significantly increases when the medicine is stopped. It is recommended to use another anticoagulant while discontinuing the use of Xarelto to lower the risk of blood clots.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">An overdose on Xarelto will increase the risk of bleeding. However, concentrations of rivaroxaban in the blood <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">don\u2019t go up further after doses exceed 50 mg<\/span><\/a><span style=\"font-weight: 400;\">, so there is an upper limit to an overdose. If too much Xarelto is taken, a Xarelto antidote can reverse the effects of the anticoagulant. Call a poison helpline or get medical attention if an overdose is suspected.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Restrictions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Most injuries and deaths caused by oral coagulants like Xarelto are due to severe bleeding episodes. Healthcare professionals, then, may avoid prescribing the drug to people at a high risk for bleeding.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Xarelto contraindications include pre-existing medical conditions that make rivaroxaban too risky to take. Xarelto may be avoided in<\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/610203\/Xarelto\/Contradindications-Cautions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\"> people with<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><b><\/b><\/p>\n<ul>\n<li><b>Active major bleeding: <\/b><span style=\"font-weight: 400;\">Xarelto can worsen an existing bleeding crisis.<\/span><\/li>\n<li><b>Moderate to severe liver impairment: <\/b><span style=\"font-weight: 400;\">Because the liver metabolizes rivaroxaban, moderate to severe liver problems can increase levels of Xarelto in the blood and increase the risk of bleeding.<\/span><\/li>\n<li><b>Coagulopathy-associated liver disease: <\/b><span style=\"font-weight: 400;\">Coagulopathy is a liver problem that can decrease the ability of the body to form blood clots, so taking rivaroxaban may increase the risk of severe bleeding episodes with this problem.<\/span><\/li>\n<li><b>Severe kidney impairment: <\/b><span style=\"font-weight: 400;\">The kidneys are partly responsible for eliminating rivaroxaban from the body. Severe kidney impairment raises the risk for severe bleeding.<\/span><\/li>\n<li><b>Severe allergic reactions to Xarelto: <\/b><span style=\"font-weight: 400;\">Xarelto may cause serious allergic reactions, including anaphylaxis, in those who are allergic to any ingredients in the drug.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Although not contraindicated, Xarelto is generally avoided or used with great caution <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610#S5.2\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">in people with<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><b><\/b><\/p>\n<ul>\n<li><b>A high risk for bleeding: <\/b><span style=\"font-weight: 400;\">Healthcare providers will assess the risk for bleeding and may not prescribe Xarelto if there are too many risk factors for bleeding problems. These risk factors include uncontrolled <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/blood-pressure-treatment-and-medications\"><span style=\"font-weight: 400;\">high blood pressure<\/span><\/a><span style=\"font-weight: 400;\">, recent surgery, heart disease, <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/diabetes-treatment-and-medications\"><span style=\"font-weight: 400;\">diabetes<\/span><\/a><span style=\"font-weight: 400;\">, alcohol abuse, and others.<\/span><\/li>\n<li><b>Mechanical heart valve: <\/b><span style=\"font-weight: 400;\">People with a prosthetic heart valve may have an increased risk of bleeding or blood clots when taking Xarelto.<\/span><\/li>\n<li><b>Antiphospholipid syndrome: <\/b><span style=\"font-weight: 400;\">An autoimmune condition associated with <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/lupus-treatment-and-medications\"><span style=\"font-weight: 400;\">lupus<\/span><\/a><span style=\"font-weight: 400;\">, triple positive antiphospholipid syndrome puts people at a higher risk for blood clots when they\u2019re taking Xarelto.<\/span><\/li>\n<li><b>Some types of pulmonary embolism: <\/b><span style=\"font-weight: 400;\">Xarelto may be avoided in people with pulmonary embolism who also have poor circulation or unstable blood pressure.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Other pre-existing conditions may require closer monitoring for side effects or possibly reduced doses. These include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mild liver impairment<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mild to moderate kidney problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A moderate risk for bleeding<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Unlike other anticoagulants such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\"><span style=\"font-weight: 400;\">warfarin<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5696313\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">there are no dietary restrictions or rules prohibiting dietary changes<\/span><\/a><span style=\"font-weight: 400;\"> for Xarelto<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Pregnancy and nursing<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Healthcare providers may prescribe Xarelto with caution in pregnant and nursing women. <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">There is a risk<\/span><\/a><span style=\"font-weight: 400;\"> that Xarelto can cause maternal bleeding and emergent delivery, as well as <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/610213\/Xarelto\/Pregnancy-Lactation\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">possible harm to the fetus<\/span><\/a><span style=\"font-weight: 400;\">. There are no laboratory tests that can closely track the effects of Xarelto on blood clotting. Pregnant women should always discuss with a healthcare professional the risks and benefits of taking oral anticoagulants when pregnant. Even if a pregnancy is not being planned, the prescribing healthcare provider may need to assess a woman of reproductive age for uterine bleeding risks while taking Xarelto.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It hasn\u2019t been determined if Xarelto is safe to take when breastfeeding. Rivaroxaban is present in human breast milk, but healthcare providers are uncertain about the risks to the nursing baby. Women who are breastfeeding should talk to their healthcare provider about the possible risks and alternative anticoagulants.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Children<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The U.S. Food and Drug Administration <\/span><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610#S5.2\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">has not approved<\/span><\/a><span style=\"font-weight: 400;\"> the use of Xarelto in children.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Seniors<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">People older than 65 can take Xarelto in the same doses as younger adults. In <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/202439_S035_022406S037lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">clinical trials<\/span><\/a><span style=\"font-weight: 400;\">, however, older patients were more likely to experience bleeding or blood clot problems than younger adults.\u00a0<\/span><\/p>\n<h2 id=\"interactions\">Xarelto interactions<\/h2>\n<p><span style=\"font-weight: 400;\">Like most prescription drugs, Xarelto can interact with other prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The most serious side effect of Xarelto is bleeding, so the most serious Xarelto drug interactions involve drugs that interfere with the body\u2019s ability to form blood clots. These drugs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Defitelio (defibrotide), a blood-thinner, and Mifeprex (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/mifepristone\"><span style=\"font-weight: 400;\">mifepristone<\/span><\/a><span style=\"font-weight: 400;\">), a drug used to end a pregnancy, are usually avoided with Xarelto because of an increased risk for severe bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other anticoagulants<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aspirin and aspirin-containing medicines<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nonsteroidal anti-inflammatory drugs (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/nsaids\"><span style=\"font-weight: 400;\">NSAIDs<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Selective serotonin reuptake inhibitors (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/ssris\"><span style=\"font-weight: 400;\">SSRIs<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Serotonin and norepinephrine reuptake inhibitors (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/snris\"><span style=\"font-weight: 400;\">SNRIs<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Some drugs significantly increase the risk for bleeding because they inhibit the body\u2019s ability to break down Xarelto. Strong CYP3A4 inhibitors may need to be discontinued, but weaker ones may be taken at lower doses. Drugs that are especially strong at inhibiting the breakdown of rivaroxaban include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-do-antibiotics-work\/\"><span style=\"font-weight: 400;\">antibiotic<\/span><\/a><span style=\"font-weight: 400;\">s<\/span><span style=\"font-weight: 400;\"> like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/erythromycin\"><span style=\"font-weight: 400;\">erythromycin<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antifungals\"><span style=\"font-weight: 400;\"> antifungal medications<\/span><\/a><span style=\"font-weight: 400;\"> such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ketoconazole\"><span style=\"font-weight: 400;\">ketoconazole<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/itraconazole\"><span style=\"font-weight: 400;\">itraconazole<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Some HIV drugs like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ritonavir\"><span style=\"font-weight: 400;\">ritonavir<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\">Finally, some drugs, including <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/barbiturates\"><span style=\"font-weight: 400;\">barbiturates<\/span><\/a><span style=\"font-weight: 400;\"> (like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/phenobarbital\"><span style=\"font-weight: 400;\">phenobarbital<\/span><\/a><span style=\"font-weight: 400;\">), some anticonvulsants (like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/carbamazepine\"><span style=\"font-weight: 400;\">carbamazepine<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/phenytoin-sodium\"><span style=\"font-weight: 400;\">phenytoin<\/span><\/a><span style=\"font-weight: 400;\">), and some antibiotics (like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/rifampin\"><span style=\"font-weight: 400;\">rifampin<\/span><\/a><span style=\"font-weight: 400;\">), speed up the body\u2019s metabolism of rivaroxaban, making patients more vulnerable to blood clots. These drugs may need to be avoided while taking Xarelto. In some cases, these drugs may need to be changed or the doses reduced before taking Xarelto.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Be careful: some commonly-used supplements like <\/span><span style=\"font-weight: 400;\">St. John\u2019s wort<\/span><span style=\"font-weight: 400;\"> can also interact with Xarelto. St. John\u2019s wort can speed up the metabolism of rivaroxaban and increase the risk of blood clots.<\/span><\/p>\n<h2 id=\"how-to-avoid-side-effects\">How to avoid Xarelto side effects<\/h2>\n<p><span style=\"font-weight: 400;\">All oral anticoagulants carry risks for side effects. There are, however, ways to minimize these risks.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. Take Xarelto as directed<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">As always, the best advice when taking prescription drugs is to follow the instructions given by a healthcare provider. Don\u2019t take too much, too little, or skip a dose. However, a healthcare provider\u2019s instructions for taking Xarelto can be complicated, so not only the dosing can change, but other aspects of taking the medicine may be adjusted as well.<\/span><\/p>\n<h4><strong>When should the dose be taken?<\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">Xarelto is sometimes taken once per day or twice per day; sometimes a specific time of day may be prescribed.<\/span><\/p>\n<h4><strong>Should the dose be taken with food?<\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">Sometimes, patients will be told they have a choice. However, when people are taking higher doses <a href=\"https:\/\/www.singlecare.com\/prescription\/xarelto\/dosage\">(15 mg tablets or 20 mg tablets)<\/a>, Xarelto must always be taken with food. When Xarelto is being used to reduce the risk of stroke in someone with nonvalvular atrial fibrillation, the tablet should be taken with an evening meal.<\/span><\/p>\n<h4><strong>Should other drugs be taken?<\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">Sometimes, Xarelto has to be taken with aspirin. A healthcare provider will tell you how much and when the aspirin should be taken.<\/span><\/p>\n<h4><strong>What happens if I miss a dose?<\/strong><\/h4>\n<p><span style=\"font-weight: 400;\">If you normally take a 10 mg, 15 mg, or 20 mg Xarelto tablet once per day, take the missed dose as soon as it\u2019s remembered but skip it if it\u2019s almost time for the next dose. If you normally take the 15 mg Xarelto tablet twice daily, you can take a double dose to make up for a missed dose. If you normally take the 2.5 mg Xarelto tablet twice daily, skip the missed dose and take the next one at the regularly scheduled time. Make sure you understand the healthcare provider\u2019s instructions about taking missed doses. Getting this wrong could cause serious problems.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. Read the medication guide<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Xarelto always comes with a medication guide. Read this carefully each time you fill a prescription. Anticoagulants can cause nleeding problems that can rapidly evolve into serious medical emergencies. Internal bleeding problems may not be recognized immediately. The medication guide provides information on what to watch out for and when you need to get medical attention while taking this drug.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. Tell the doctor about all medical conditions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You should give your prescribing healthcare provider a complete and accurate medical history before starting Xarelto. Make sure the prescribing healthcare provider knows about:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any history of bleeding problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pregnancy or pregnancy plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Breastfeeding or breastfeeding plans<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">4. Tell the healthcare provider about all medications being taken<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Taking some drugs with Xarelto can significantly increase the likelihood of bleeding episodes, so tell the prescribing healthcare professional about all prescription drugs, over-the-counter medications, and supplements you\u2019re taking, particularly:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aspirin or aspirin-containing products<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">NSAIDs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other blood thinners like Coumadin (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\"><span style=\"font-weight: 400;\">warfarin<\/span><\/a><span style=\"font-weight: 400;\">), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/plavix\"><span style=\"font-weight: 400;\">Plavix<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/clopidogrel-bisulfate\"><span style=\"font-weight: 400;\">clopidogrel<\/span><\/a><span style=\"font-weight: 400;\">), or Lovenox (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/enoxaparin-sodium\"><span style=\"font-weight: 400;\">enoxaparin<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">SSRIs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">SNRIs<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">5. Get medical help at any sign of bleeding problems<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The most serious problem with anticoagulants is bleeding, which can happen anywhere in the body and quickly escalate into an emergency medical situation. Internal bleeding is not easily detected, so it\u2019s important to know the signs of bleeding problems. Even minor external bleeding events, like frequent nosebleeds, can indicate there\u2019s a potential serious problem. Get medical attention at any sign of a bleeding problem such as:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Severe bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Frequent or prolonged nosebleeds<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Frequent or prolonged bleeding from the gums<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Heavier-than-normal menstrual bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Unexplained vaginal bleeding<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding in the urine (pink, red, or brown urine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bleeding in the stools (bright red or black and tarry stools)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coughing up blood or blood clots<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vomiting up blood (bloody vomit) or blood clots (\u201ccoffee grounds\u201d vomit)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headaches, dizziness, fainting, or weakness<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\">6. Do not stop taking Xarelto<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The sudden discontinuation of Xarelto can increase the risk of blood clots. Try not to skip a dose and never stop taking Xarelto until you\u2019ve talked to a doctor.\u00a0<\/span><\/p>\n<h2 id=\"resources\">Resources<\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/nejmoa1510991\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Andexanet alfa for the reversal of factor Xa inhibitor activity<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">New England Journal of Medicine<\/span><\/i><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.xarelto-us.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Getting started with Xarelto<\/span><\/a><span style=\"font-weight: 400;\">, Janssen<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5696313\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Metabolic benefits of rivaroxaban in non-valvular atrial fibrillation patients after radiofrequency catheter ablation<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><i><span style=\"font-weight: 400;\">Journal of Zhejiang University Science B<\/span><\/i><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.ismp.org\/system\/files\/resources\/2019-02\/2016Q4.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">QuarterWatch, July 12, 2017<\/span><\/a><span style=\"font-weight: 400;\">, Institute for Safe Medication Practices<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/9875401\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Rivaroxaban compound summary<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.pdr.net\/drug-summary\/Xarelto-rivaroxaban-278\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Rivaroxaban drug summary<\/span><\/a><span style=\"font-weight: 400;\">, Prescriber\u2019s Digital Reference<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/610210\/Xarelto\/Monograph\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Xarelto<\/span><\/a><span style=\"font-weight: 400;\">, Epocrates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/online.epocrates.com\/drugs\/610201\/Xarelto\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Xarelto prescribing information<\/span><\/a><span style=\"font-weight: 400;\">, U.S. National Library of Medicine<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Xarelto side effects | Serious side effects | Bleeding | Reversal | How long do side effects last? | Warnings | Interactions | How to avoid side effects Resources Xarelto is a brand-name prescription oral anticoagulant used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). It can also be used to prevent deep [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":45308,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[9650,788,737,12752],"coauthors":[8861],"class_list":["post-45301","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-blood-thinners","tag-drug-safety","tag-heart-health","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Xarelto side effects, interactions, and how to avoid them | SingleCare<\/title>\n<meta name=\"description\" content=\"Bleeding, back pain, and dizziness are common Xarelto side effects. 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