Rivaban
Generic Name
Rivaroxaban
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rivaban 10 mg tablet | ৳ 25.00 | ৳ 250.00 |
| rivaban 20 mg tablet | ৳ 45.00 | ৳ 450.00 |
| rivaban 25 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Rivaban (Rivaroxaban) is an oral anticoagulant used to prevent and treat blood clots. It is commonly prescribed for conditions such as atrial fibrillation to prevent stroke, and for the treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE).
Uses & Indications
Dosage
Adults
For stroke prevention in NVAF: 20 mg once daily with food. For DVT/PE treatment: 15 mg twice daily with food for 21 days, followed by 20 mg once daily with food. For DVT/PE prophylaxis after hip/knee replacement: 10 mg once daily.
Elderly
No specific dose adjustment required based on age alone, but renal function should be assessed.
Renal_impairment
For severe renal impairment (CrCl 15-50 mL/min), dose adjustment may be necessary. For CrCl <15 mL/min, generally not recommended.
How to Take
Take orally with food. For doses of 15 mg and 20 mg, it should be taken with food. The 2.5 mg and 10 mg doses can be taken with or without food.
Mechanism of Action
Rivaroxaban is a highly selective direct inhibitor of Factor Xa. By inhibiting Factor Xa, it interrupts the intrinsic and extrinsic pathways of the blood coagulation cascade, leading to the inhibition of thrombin formation and thrombi development.
Pharmacokinetics
Onset
Anticoagulant effects observed within 2-4 hours.
Excretion
Approximately 2/3 of the dose is excreted via the kidneys (1/3 unchanged, 1/3 as inactive metabolites), and 1/3 via the fecal/biliary route.
Half life
5 to 9 hours in young adults, 11 to 13 hours in elderly patients.
Absorption
Rapidly absorbed with peak concentrations occurring 2-4 hours after administration. Oral bioavailability is high (80-100%) for 2.5 mg and 10 mg doses, but lower (66%) for 20 mg when taken without food.
Metabolism
Metabolized in the liver primarily by CYP3A4, CYP2J2, and CYP-independent mechanisms.
Side Effects
Contraindications
- Active pathological bleeding (e.g., active gastrointestinal bleeding, intracranial hemorrhage).
- Known hypersensitivity to Rivaroxaban or any component of the formulation.
- Severe hepatic disease associated with coagulopathy and clinically relevant bleeding risk.
- Pregnancy and lactation.
Drug Interactions
NSAIDs, Aspirin, SSRIs, SNRIs
Increase bleeding risk.
Other anticoagulants (e.g., warfarin, heparin)
Increase bleeding risk.
Strong CYP3A4 and P-gp inducers (e.g., rifampicin, phenytoin)
Decrease Rivaroxaban exposure and efficacy.
Strong CYP3A4 and P-gp inhibitors (e.g., ketoconazole, ritonavir)
Increase Rivaroxaban exposure and bleeding risk.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to increased bleeding risk. No specific antidote exists for Rivaroxaban; activated charcoal may be used to reduce absorption. Andexanet alfa is a specific reversal agent. Symptomatic treatment and supportive measures should be initiated.
Pregnancy & Lactation
Contraindicated during pregnancy due to potential for fetal bleeding and reproductive toxicity. Avoid use during lactation as Rivaroxaban is excreted in breast milk.
Side Effects
Contraindications
- Active pathological bleeding (e.g., active gastrointestinal bleeding, intracranial hemorrhage).
- Known hypersensitivity to Rivaroxaban or any component of the formulation.
- Severe hepatic disease associated with coagulopathy and clinically relevant bleeding risk.
- Pregnancy and lactation.
Drug Interactions
NSAIDs, Aspirin, SSRIs, SNRIs
Increase bleeding risk.
Other anticoagulants (e.g., warfarin, heparin)
Increase bleeding risk.
Strong CYP3A4 and P-gp inducers (e.g., rifampicin, phenytoin)
Decrease Rivaroxaban exposure and efficacy.
Strong CYP3A4 and P-gp inhibitors (e.g., ketoconazole, ritonavir)
Increase Rivaroxaban exposure and bleeding risk.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to increased bleeding risk. No specific antidote exists for Rivaroxaban; activated charcoal may be used to reduce absorption. Andexanet alfa is a specific reversal agent. Symptomatic treatment and supportive measures should be initiated.
Pregnancy & Lactation
Contraindicated during pregnancy due to potential for fetal bleeding and reproductive toxicity. Avoid use during lactation as Rivaroxaban is excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by DGDA and international regulatory bodies
Patent Status
Patent expired for original compound, generic versions available
Clinical Trials
Rivaroxaban has been extensively studied in various large-scale clinical trials such as ROCKET AF (stroke prevention in AF), EINSTEIN-DVT/PE (DVT/PE treatment), and COMPASS (CAD/PAD patients).
Doctor Notes
- Carefully assess bleeding risk before initiating Rivaban, especially in patients with renal impairment, concomitant use of antiplatelets/NSAIDs, or those with a history of GI bleeding.
- Educate patients on bleeding symptoms and the importance of adherence. Avoid abrupt discontinuation.
- Monitor renal function periodically.
Missed Dose Advice
For once-daily dose, if a dose is missed, take it as soon as you remember on the same day. Do not take two doses to make up for a missed dose. For twice-daily dose, take it as soon as you remember, and continue with your next dose as usual.
Driving Precautions
Rivaban generally does not affect the ability to drive or operate machinery. However, if you experience side effects like dizziness, avoid driving or operating machinery until you feel well.
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