Xarelto

Common use

Xarelto is prescribed to prevent stroke in patients with non-valvular atrial fibrillation, to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), and to prevent clot formation after hip or knee replacement surgery. It works by blocking Factor Xa, a key component in the blood-clotting process.

Dosage and direction

Xarelto is taken orally once daily or twice daily depending on the condition being treated. It should be taken with food when prescribed at higher doses (15 mg or 20 mg). The dose must follow the doctor’s instructions, and tablets should not be crushed unless advised by a healthcare provider.

Precautions

Use with caution if you have kidney or liver disease, bleeding disorders, stomach ulcers, recent surgery, or are taking other medications that increase bleeding risk. Avoid activities that may cause injury. Do not stop taking Xarelto without medical guidance, as this increases the risk of clot formation.

Contraindications

Not recommended for patients with active pathological bleeding, severe liver impairment, or those allergic to rivaroxaban. Contraindicated in pregnancy or breastfeeding unless specifically approved by a doctor.

Possible side effect

Common side effects include bruising, nosebleeds, bleeding gums, dizziness, and stomach discomfort. Serious side effects may include severe bleeding, black stools, coughing up blood, weakness, or sudden severe headaches. Seek medical help immediately if heavy bleeding occurs.

Drug interaction

Xarelto can interact with other anticoagulants, antiplatelet drugs, NSAIDs, antidepressants (SSRIs/SNRIs), and medications that affect liver enzymes such as certain antibiotics, antifungals, antivirals, and anticonvulsants. Alcohol may increase bleeding risk.

Missed dose

Take the missed dose as soon as you remember. If taking a once-daily regimen, do not double the dose. If on twice-daily treatment, you may take two 15 mg tablets in one day if advised by your doctor.

Overdose

Overdose may cause excessive or prolonged bleeding. Immediate medical attention is required. Activated charcoal or specific reversal agents may be used in emergencies.

Storage

Store at room temperature, away from moisture, heat, and light. Keep out of reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

Clinical Verification

Last Clinically Updated: August 15, 2026

Written By

Dr. Elena Vance, PharmD

Clinical Specialist in Neuropharmacology

Fact Checked By

Marcus Thorne, MS

Biomedical Data & FDA Label Verification

Medically Reviewed By

Dr. Arthur Campbell, MD

Board-Certified Psychiatrist (ABPN)