Raviroxaban

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Raviroxaban is an anticoagulant from the group of oxazolidinones that can be administered orally. The bioavailability is 80-100%, the half-life is 7-11 hours.

Dosage and method of use
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10 mg/day p.o. for thrombosis prophylaxis only for endoprosthetics

20 mg/day p.o. for the prophylaxis of strokes and systematic embolisms in adults with non-valvular atrial fibrillation and one or more risk factors such as stroke or TIA in the medical history

Furthermore the therapy of deep vein thrombosis and pulmonary embolism as well as the prophylaxis of recurrent deep vein thrombosis and pulmonary embolism in adults.

The duration of therapy and dosage must be weighed against the risk of bleeding for each indication.

  • Prophylaxis of VTE after elective hip or knee replacement surgery: For this indication, the recommended dose is 10 mg of the active substance per day. The first dose should be administered 6-10 hours postoperatively. In the case of major hip surgery, a treatment period of 5 weeks is recommended. For major knee surgery a treatment period of 2 weeks is recommended.
  • Treatment of DVT, LE and prophylaxis of recurrent DVT and LE: The recommended initial dose for this indication is 15 mg twice daily for the first three weeks, then 20 mg once daily for further treatment or prophylaxis for at least 3 months. If the therapy is continued for more than 6 months, a daily dose of 10 mg rivaroxaban is recommended and in exceptional cases 20 mg daily.
  • Switching from vitamin K antagonists to rivaroxaban: In patients who are to be switched from rivaroxaban to vitamin K antagonists, treatment with vitamin K antagonists should be stopped and rivaroxaban therapy should be started as soon as the INR is <2.5.
  • Switching from rivaroxaban to vitamin K antagonists: In patients who are to be switched from rivaroxaban to vitamin K antagonists, the vitamin K antagonist should be given simultaneously until the INR is >2.0. During the first two days, the regular initial dose of vitamin K antagonist should be used, followed by a dose based on INR values. For more detailed information, please refer to the respective scientific information.
  • Switching from parenterally administered anticoagulants to rivaroxaban: In patients who are switching from parenterally administered anticoagulants to rivaroxaban, the parenterally administered anticoagulant should be discontinued and rivaroxaban should be taken 0-2 hours before the time at which the parenterally administered anticoagulant was scheduled to be administered.
  • Switching from rivaroxaban to parenteral anticoagulants: In patients who are switching from rivaroxaban to parenteral anticoagulants, the first dose of the parenteral anticoagulant should be given at the time when the next dose of rivaroxaban would have been taken.
  • Further indications:

In renal insufficiency, dose reduction to 15mg/day p.o.

Undesirable effects
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Bleeding, aching limbs, nausea, fever, weakness, itching skin.

Contraindication
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Pregnancy.

Preparations
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Xarelto®

Incoming links (2)

Factor x; Factor xa inhibitors;

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Last updated on: 29.10.2020