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Direct Oral Anticoagulant / AF / ACS

Rivaroxaban (AF / ACS)

Brand names: Xarelto

Used in: Venous Thromboembolism (DVT & PE)

Rivaroxaban is a direct oral anticoagulant (a factor Xa inhibitor) used for stroke prevention in non-valvular atrial fibrillation, for treatment and prevention of venous thromboembolism, and at low dose for vascular protection in coronary or peripheral arterial disease.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Rivaroxaban directly and reversibly inhibits activated factor X (factor Xa), reducing thrombin generation and clot formation.

Prescribing in practice

  • The dose depends on the indication; treatment doses must be taken with food for reliable absorption.
  • Renal function affects dosing and suitability — avoid in severe renal impairment and review eGFR periodically.
  • It interacts with strong dual CYP3A4 and P-glycoprotein inhibitors or inducers; review co-medication.

Monitoring

No routine coagulation monitoring; check renal and hepatic function and full blood count at baseline and periodically.

Counselling the patient

  • Take treatment doses with food, at the same time each day.
  • Do not miss doses — protection wears off quickly.
  • Report unusual bleeding and tell clinicians or dentists you take an anticoagulant.

Evidence & guidelines

DOACs are recommended first-line over warfarin for non-valvular AF in NICE NG196; AF efficacy was shown in ROCKET-AF.

Reference: ROCKET-AF Trial (Patel et al. NEJM 2011); ATLAS ACS2-TIMI 51 (Mega et al. NEJM 2012); NICE TA256; SPC Xarelto; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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