Rivaroxaban is a popular blood thinner many doctors prescribe to prevent strokes, treat or prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), and lower clot risk after hip or knee surgery. It’s simple to take (usually once daily) but it’s powerful — so knowing the basics can keep you safe.
Rivaroxaban blocks a key clotting protein. That lowers the chance of dangerous clots but raises bleeding risk. Here are common dose patterns you’ll see:
- Atrial fibrillation (to prevent stroke): 20 mg once daily with food. If kidney function is reduced (CrCl 15–50 mL/min) doctors often use 15 mg once daily.
- DVT/PE treatment: often 15 mg twice daily for the first 21 days, then 20 mg once daily with food.
- After hip or knee replacement: 10 mg once daily for a short course.
Follow your prescriber’s exact plan — doses change with your kidney function, the condition being treated, and other medicines you take.
Want to lower your risk of complications? Start here.
- Watch for signs of bleeding: heavy bruising, pink or brown urine, black or bloody stools, coughing/vomiting blood, or severe headaches and confusion. Get urgent care if these happen.
- Drug interactions matter. Strong CYP3A4 and P‑gp inhibitors (like ketoconazole or certain HIV drugs) can raise rivaroxaban levels and increase bleeding. Strong inducers (rifampin, carbamazepine, St. John’s wort) can lower its effect. Over‑the‑counter NSAIDs and aspirin raise bleeding risk when taken with rivaroxaban.
- Kidney checks. Because rivaroxaban clears partly through the kidneys, your doctor will check kidney function before and during treatment. Dosing may change if your kidneys aren’t working well.
- Missed dose? If you take it once daily, take the missed dose as soon as you remember that day. Don’t double up the next day. For the early 15 mg twice‑daily phase, take the missed pill as soon as you remember so you don’t miss the full day’s dose.
- Surgery or procedures: don’t stop and restart on your own. Talk to the clinician who knows the procedure — many patients stop rivaroxaban 24–48 hours before a planned operation depending on bleeding risk and kidney function. Stopping too long can raise clot risk.
- Reversal: if major bleeding occurs, hospitals can use reversal strategies. There’s a specific antidote (andexanet alfa) and other emergency options. That’s why telling ER staff you’re on rivaroxaban matters.
Got questions about switching from warfarin, pregnancy, or how long you’ll need blood thinners? Bring them up with your prescriber. Practical talk beats guessing — and it keeps you safer while on rivaroxaban.
