Rivarox
Generic Name
Rivaroxaban
Manufacturer
XYZ Pharmaceuticals
Country
United States
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| rivarox 25 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
Rivaroxaban 2.5 mg tablet is an oral anticoagulant, a direct factor Xa inhibitor, used to prevent blood clots and reduce the risk of major cardiovascular events in specific patient populations.
Uses & Indications
Dosage
Adults
2.5 mg orally twice daily with aspirin 75-100 mg once daily, for patients with CAD or PAD.
Elderly
No dose adjustment is required based on age; however, increased bleeding risk should be considered.
Renal_impairment
Avoid in patients with CrCl < 15 mL/min. Use with caution in CrCl 15-50 mL/min, with close monitoring for bleeding.
How to Take
Take orally, with or without food, twice daily. For 2.5 mg, food intake is not critical.
Mechanism of Action
Rivaroxaban selectively and directly inhibits Factor Xa (FXa), which is crucial in the coagulation cascade. By inhibiting FXa, it prevents the generation of thrombin and the formation of blood clots.
Pharmacokinetics
Onset
Anticoagulant effect observed within 2-4 hours.
Excretion
Approximately one-third excreted unchanged renally; two-thirds excreted as inactive metabolites via renal and fecal/biliary routes.
Half life
5-9 hours in healthy adults; 9-13 hours in elderly.
Absorption
Rapidly absorbed, high oral bioavailability (80-100% for 2.5 mg dose), peak plasma concentrations reached in 2-4 hours.
Metabolism
Primarily hepatic metabolism via CYP3A4, CYP2J2, and CYP-independent hydrolysis.
Side Effects
Contraindications
- Active pathological bleeding (e.g., intracranial hemorrhage, gastrointestinal bleeding).
- Severe hypersensitivity to rivaroxaban.
- Hepatic disease associated with coagulopathy and clinically relevant bleeding risk.
- Pregnancy and lactation.
Drug Interactions
Other anticoagulants (e.g., warfarin, heparin)
Concomitant use significantly increases bleeding risk and is generally not recommended.
Strong CYP3A4 inducers (e.g., rifampicin, phenytoin)
Decrease rivaroxaban exposure, potentially reducing efficacy.
Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
Increase rivaroxaban exposure and bleeding risk.
NSAIDs and antiplatelet agents (e.g., aspirin, clopidogrel)
Concomitant use increases bleeding risk. Use with caution.
Storage
Store below 30°C (86°F), protect from moisture and light. Keep out of reach of children.
Overdose
Overdose of rivaroxaban can lead to an increased risk of bleeding. Management includes activated charcoal if administered shortly after overdose to reduce absorption, and symptomatic and supportive treatment. Specific antidote (andexanet alfa) is available.
Pregnancy & Lactation
Rivaroxaban is not recommended during pregnancy due to potential fetal harm. It is unknown if rivaroxaban is excreted in human milk, so breastfeeding is not recommended.
Side Effects
Contraindications
- Active pathological bleeding (e.g., intracranial hemorrhage, gastrointestinal bleeding).
- Severe hypersensitivity to rivaroxaban.
- Hepatic disease associated with coagulopathy and clinically relevant bleeding risk.
- Pregnancy and lactation.
Drug Interactions
Other anticoagulants (e.g., warfarin, heparin)
Concomitant use significantly increases bleeding risk and is generally not recommended.
Strong CYP3A4 inducers (e.g., rifampicin, phenytoin)
Decrease rivaroxaban exposure, potentially reducing efficacy.
Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
Increase rivaroxaban exposure and bleeding risk.
NSAIDs and antiplatelet agents (e.g., aspirin, clopidogrel)
Concomitant use increases bleeding risk. Use with caution.
Storage
Store below 30°C (86°F), protect from moisture and light. Keep out of reach of children.
Overdose
Overdose of rivaroxaban can lead to an increased risk of bleeding. Management includes activated charcoal if administered shortly after overdose to reduce absorption, and symptomatic and supportive treatment. Specific antidote (andexanet alfa) is available.
Pregnancy & Lactation
Rivaroxaban is not recommended during pregnancy due to potential fetal harm. It is unknown if rivaroxaban is excreted in human milk, so breastfeeding is not recommended.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, varies by manufacturer and specific product.
Availability
Pharmacies, Hospitals
Approval Status
FDA/DGDA Approved
Patent Status
Patent Expired/Expiring
Clinical Trials
The COMPASS trial demonstrated the efficacy and safety of rivaroxaban 2.5 mg twice daily plus aspirin for reducing cardiovascular events in patients with CAD or PAD.
Lab Monitoring
- No routine coagulation monitoring (e.g., PT/INR, aPTT) is required. Monitor for signs and symptoms of bleeding, complete blood count (CBC), and renal function (CrCl).
- Liver function tests if clinically indicated.
Doctor Notes
- Assess bleeding risk factors (e.g., age, renal function, concomitant medications, history of bleeding) before initiating and during treatment.
- Educate patients on bleeding symptoms and the importance of adherence and not discontinuing prematurely.
- Consider specific antidote (andexanet alfa) availability in case of life-threatening bleeding.
Patient Guidelines
- Take rivaroxaban exactly as prescribed by your doctor.
- Do not stop taking this medicine without consulting your doctor, as this may increase your risk of blood clots.
- Report any signs of unusual bleeding or bruising to your doctor immediately.
- Inform your doctor or dentist that you are taking rivaroxaban before any surgery or dental procedure.
Missed Dose Advice
If a dose is missed, take it as soon as you remember on the same day. Do not take two doses at the same time to make up for a missed dose.
Driving Precautions
Rivaroxaban has no or negligible influence on the ability to drive and use machines. However, dizziness (a common side effect) may affect driving ability in some individuals.
Lifestyle Advice
- Avoid activities that may increase your risk of injury or bleeding.
- Maintain good oral hygiene to reduce the risk of gum bleeding.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements.
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