Rivaroxaban, a novel oral anticoagulant, plays an important role in the prevention and treatment of thromboembolic diseases. Compared with traditional anticoagulants, rivaroxaban has the characteristics of definite curative effect, good safety, convenient use, and no need to monitor blood coagulation indicators frequently. It is widely used in hip (or knee) joint replacement, deep vein thrombosis, and pulmonary embolism. , non-valvular atrial fibrillation and other diseases prevention and treatment.
How many strengths does Rivaroxaban come in? How to distinguish?
Rivaroxaban is available in three sizes: 10mg, 15mg, and 20mg, and their colors are light red, red, and brown-red respectively. These three specifications are only different in dosage, and the ingredients are the same. The doctor will formulate different dosage regimens according to different conditions, strictly follow the doctor's prescribed dosage, and do not arbitrarily increase or decrease the dosage.
Do you take the medicine before or after meals?
Rivaroxaban 10mg strength:
Gastrointestinal absorption is not affected by food and can be taken before or after meals. 10mg of rivaroxaban is almost completely absorbed, whether in fasting or full state, with an absolute bioavailability of 80% to 100%.
Rivaroxaban in 15mg and 20mg strengths:
The bioavailability of the drug taken before meals is only 66%, and food can promote the absorption of the drug, so it needs to be taken with food. Compared with pre-prandial administration, the bioavailability of postprandial administration was increased by 39%, and the peak concentration was increased by 76%, with a significant food effect.
For patients who cannot swallow whole tablets, 10mg, 15mg or 20mg rivaroxaban tablets may be crushed before administration, mixed with applesauce and taken orally immediately after administration of crushed rivaroxaban 15mg or 20mg tablets , it is recommended to eat immediately.
For patients administered by gastric tube or gastric feeding tube, 10 mg, 15 mg or 20 mg of rivaroxaban tablets can be crushed, mixed with 50 ml of water to form a suspension, and administered by nasogastric tube or nasogastric feeding tube. Because the absorption of rivaroxaban is dependent on the site of drug release, distal gastric administration should be avoided, as distal gastric administration may decrease drug absorption and thus reduce drug exposure. Food should be given by enteral nutrition immediately after administration of crushed rivaroxaban 15 mg or 20 mg tablets.
Is 20mg rivaroxaban good to take with breakfast? Or take it with dinner? Does meal type affect the absorption of 20 mg of rivaroxaban?
Clinical studies have shown that 20mg rivaroxaban tablets can be taken with breakfast or with dinner, and there is no significant difference in drug absorption. Therefore, whether it is taken with breakfast or with dinner, try to take it at the same time to avoid missed doses. Diet type also had no relevant effect on the absorption of 20 mg of rivaroxaban. Although administration of rivaroxaban with food is necessary to maintain high bioavailability, the content of meals does not appear to affect the bioavailability of rivaroxaban.
What should I do if I miss it?
For patients taking 15 mg orally twice daily: Rivaroxaban should be taken immediately to ensure daily intake of 30 mg of rivaroxaban. Two 15mg tablets can be taken at a time.
For patients taking 20 mg, 15 mg, or 10 mg orally once daily: Rivaroxaban should be taken immediately and continue to receive once daily dosing the following day. Dosing should not be doubled within a day to make up for a missed dose.
Can I take rivaroxaban during pregnancy and breastfeeding?
Rivaroxaban increases the risk of bleeding in patients, and when used in pregnancy, fetal or placental hemorrhage may also occur, increasing the risk of miscarriage, preterm birth, or fetal damage, therefore, its use in pregnant women is not recommended. If continued use, fetal hemorrhage assessment and preterm birth risk assessment are recommended. Rivaroxaban may be excreted into breast milk, please consult your physician or pharmacist before breastfeeding.
Is there anything else to watch out for?
1. Rivaroxaban is mainly metabolized by CYP3A4 and is a substrate of the transporter protein P-glycoprotein (P-gp). Therefore, rivaroxaban should not be used in combination with itraconazole, voriconazole, and posaconazole.
2. Before surgery or tooth extraction is required, please inform your doctor or dentist that you are taking this medicine and ask whether you need to stop the medicine before surgery.
3. Taking rivaroxaban can be used for proper exercise. Strenuous exercise that may cause trauma should be avoided, and attention should be paid to preventing falls and injuries.
4. Excessive anticoagulation can easily lead to bleeding. For severe bleeding, such as bleeding in urine and stool or sudden headache, dizziness, nausea, vomiting, etc., stop the drug and seek medical attention immediately.