Rivaroxaban

• In Aotearoa New Zealand rivaroxaban comes as tablets which are available in different strengths: 10 mg, 15 mg and 20 mg.
• Your dose of rivaroxaban will depend on what it's being used for.
• Your healthcare provider or pharmacist will tell you the strength that's right for you.
• How long you will need to take rivaroxaban for will depend on why you're taking it. Some people only need it for a few weeks (eg, after surgery), or for a few months (eg, for deep vein thrombosis). Others may need to take it for the rest of their lives (people with atrial fibrillation).
• Always take your rivaroxaban exactly as your healthcare provider has told you. The pharmacy label will tell you how much rivaroxaban to take, how often to take it and any special instructions.

• Know your tablet strength: Rivaroxaban tablets are available in different strengths: 10 mg, 15 mg and 20 mg. If you're not sure which tablet strength you're taking, ask your pharmacist.
• Timing: Take your rivaroxaban dose at the same times each day. Rivaroxaban is best taken with food. If you are taking 10 mg once daily, you can take the tablet with or without food.    
• Swallow your tablets with a glass of water: If you can't swallow the tablet, you can crush it and mix it with a little water or apple puree, just before taking it.
• Missed dose: Missing doses increases your risk of getting blood clots. If you forget to take your dose, follow these instructions or contact your pharmacist or healthcare provider.
  • If you're taking rivaroxaban ONCE A DAY: Take the missed dose as soon as you remember on the same day. 
  • If you're taking rivaroxaban TWICE A DAY: Take the missed dose as soon as you remember. If needed, you can take your first dose with your second dose of the day. Continue your regular dose twice daily the next day.  

When taking rivaroxaban, it's important to use the medicine safely and correctly. The benefits of rivaroxaban need to be carefully balanced with possible side effects. Not enough anticoagulation can lead to a blood clot or stroke, but too much anticoagulation can lead to serious bleeding.

Here are some things to know when you're taking rivaroxaban. Other things may be important as well, so ask your healthcare provider what you should know about.

You might bleed or bruise more easily while you're taking rivaroxaban

• Be careful when shaving, clipping fingernails, brushing and flossing your teeth, or playing sports.
• Avoid new tattoos and piercings as these can cause bruising and bleeding.
• If you have a fall or hurt your head or body, get medical attention immediately, even if you feel okay.
• Some types of bleeding are more serious than others. If bleeding concerns you, is heavier than usual or takes an unusually long time to stop, you should talk to your healthcare provider quickly.
  
  

Other things to be aware of

• Tell all healthcare providers that you're taking rivaroxaban (eg, your doctor, dentist, pharmacist or podiatrist). You may need to stop taking your anticoagulant before surgery, dental care and some tests.
• Taking other medicines: Rivaroxaban can interact with some medicines and herbal supplements, so check with your healthcare provider or pharmacist before starting rivaroxaban and before starting any new products. This includes over-the-counter anti-inflammatories including diclofenac (eg, Voltaren Rapid), ibuprofen (eg, Nurofen) and naproxen (eg, Naprogesic).
• Pregnancy: Rivaroxaban isn’t given to pregnant women. If you're taking it and could become pregnant, talk to your healthcare provider about contraception. If you're on rivaroxaban and find out you're pregnant (or you're planning a pregnancy) talk to your healthcare provider or anticoagulant clinic about stopping or changing your prescription.

Like all medicines, rivaroxaban can cause side effects, although not everyone gets them. If you're concerned about any symptoms you think might be related to your medicine, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.

Common side effects

Tell your healthcare provider if these bother you.

• Nausea (feeling sick).
• Indigestion, tummy cramps.
• Headache.
  
  

Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur

• Signs of bleeding, such as unexpected bruises, bleeding gums or nosebleeds.
• For women, if you notice heavier bleeding during your period than before starting rivaroxaban, continue your rivaroxaban and see your healthcare provider as there are ways to manage heavy periods.
  
  

Phone 111 for an ambulance or go to your nearest accident and emergency (A&E) clinic if these occur

• You have difficulty breathing or pain in your chest.
• You have pain or swelling in your legs.
• You have symptoms of a stroke such as face drooping, arm weakness, speech difficulty, confusion, trouble seeing, trouble walking.
• You've had a serious fall or injury to your head.
• Signs of severe bleeding such as coughing up blood or vomiting blood or there is blood in your urine (wee) or bowel motions (poo).
• You have bleeding that won’t stop after 10 minutes of applying pressure.

Read more about medicines and side effects and reporting a reaction that you think might be a side effect.
Find out what to do if you think a child or someone else has taken a medicine that's not for them.