Xarelto 20
Xarelto 20 is Bayer’s rivaroxaban 20 mg tablets — the first oral direct factor Xa inhibitor. ROCKET-AF (2011) non-inferior to warfarin in non-valvular AF; EINSTEIN-DVT/PE (2010) established single-drug treatment for VTE. COMPASS (2017) showed 2.5 mg twice daily + aspirin reduced CV events in stable CAD/PAD. No routine blood monitoring needed (vs warfarin INR). Contraindicated in mechanical valves, pregnancy, severe CKD. Andexanet alfa reverses in emergencies.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Xarelto 20?
Xarelto 20 is 20 mg rivaroxaban tablets from Bayer — direct oral anticoagulant (DOAC) — direct factor Xa inhibitor. Rivaroxaban was introduced by Bayer in 2008 as Xarelto — the first oral direct factor Xa inhibitor. ROCKET-AF (2011) and EINSTEIN-DVT/PE (2010) established non-inferiority to warfarin in AF and VTE. directly inhibits factor Xa, the central convergence point of intrinsic and extrinsic coagulation cascades, reducing thrombin generation. 5-13 hour half-life; renally and hepatically cleared. Dosing: Non-valvular AF: 20 mg once daily with food (15 mg if CrCl 15-50 mL/min). DVT/PE treatment: 15 mg twice daily for 3 weeks then 20 mg once daily. COMPASS vascular prophylaxis: 2.5 mg twice daily with aspirin 75-100 mg daily. Major bleeding ~3-5%/year in AF; GI bleeding somewhat higher than warfarin. No routine monitoring unlike warfarin — a major practical advantage. Reversal with andexanet alfa (specific antidote) where available, or 4-factor prothrombin complex concentrate. Anticoagulant and antiplatelet selection is individualised to diagnosis, bleeding risk, renal function, and drug interactions. Specialist or family-physician supervision is standard.
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What Is Xarelto 20?
Xarelto 20 is 20 mg rivaroxaban tablets from Bayer, supplied in 14-112 tablets. Rivaroxaban was introduced by Bayer in 2008 as Xarelto — the first oral direct factor Xa inhibitor. ROCKET-AF (2011) and EINSTEIN-DVT/PE (2010) established non-inferiority to warfarin in AF and VTE.
How Rivaroxaban Works
Rivaroxaban directly inhibits factor Xa, the central convergence point of intrinsic and extrinsic coagulation cascades, reducing thrombin generation. 5-13 hour half-life; renally and hepatically cleared.
Goedgekeurde Toepassingen
- Non-valvular atrial fibrillation — stroke prevention (ROCKET-AF)
- Deep vein thrombosis and pulmonary embolism — treatment (EINSTEIN trials) and extended prophylaxis
- VTE prophylaxis after major orthopaedic surgery
- Stable coronary or peripheral arterial disease — 2.5 mg twice daily + aspirin (COMPASS 2017) for atherothrombotic prevention in high-risk patients
Dosering
Non-valvular AF: 20 mg once daily with food (15 mg if CrCl 15-50 mL/min). DVT/PE treatment: 15 mg twice daily for 3 weeks then 20 mg once daily. COMPASS vascular prophylaxis: 2.5 mg twice daily with aspirin 75-100 mg daily.
Bloedingsrisico en monitoring
Major bleeding ~3-5%/year in AF; GI bleeding somewhat higher than warfarin. No routine monitoring unlike warfarin — a major practical advantage. Reversal with andexanet alfa (specific antidote) where available, or 4-factor prothrombin complex concentrate.
No routine blood monitoring required — a major practical advantage over warfarin. Check renal function at baseline, 3 months, then annually (or sooner in acute illness or 75+ years). No dietary restrictions. Missed doses: take if within 6 hours of scheduled dose; otherwise skip — do not double up.
Bijwerkingen
- Major bleeding (~3-5%/year in AF)
- GI bleeding (higher than apixaban, slightly higher than warfarin)
- Anemie
- Minor bleeding (epistaxis, bruising)
- Hepatotoxicity (rare)
Contra-indicaties
- Active pathological bleeding
- Severe renal impairment (CrCl <15 mL/min)
- Ernstige leverfunctiestoornis (Child-Pugh B of C)
- Mechanical heart valve (use warfarin)
- Moderate-to-severe mitral stenosis
- Pregnancy (crosses placenta; use heparin / warfarin)
- Concurrent strong dual inhibitors of CYP3A4 + P-gp (azole antifungals, HIV protease inhibitors)
Geneesmiddelinteracties
- Strong CYP3A4 + P-gp dual inhibitors — CRITICAL. Azole antifungals (ketoconazole, itraconazole), HIV protease inhibitors, clarithromycin — substantially raise rivaroxaban levels; contraindicated.
- Strong CYP3A4 + P-gp inducers (rifampicin, phenytoin, carbamazepine, St John’s Wort) — lower levels; avoid or monitor closely.
- Other anticoagulants, heparins — do not combine except in specific bridging situations under specialist supervision.
- NSAIDs, antiplatelets — additive bleeding risk.
Opslag
Store Xarelto 20 below 25°C. Keep out of reach of children.
Veelgestelde vragen
Do I need blood tests on Xarelto 20?
No routine blood tests for efficacy. Check renal function annually.
What should I do if I cut myself while on Xarelto 20?
Oefen gedurende 15-20 minuten stevige directe druk uit zonder te kijken. De meeste kleine snijwonden stoppen normaal; bloedingen die langer dan 20 minuten duren of door meerdere verbanden heen bloeden vereisen dringende medische beoordeling. Meld zwarte of bloederige ontlasting, helderrood rectaal bloedverlies, hematurie, onverklaarbare blauwe plekken, neusbloedingen langer dan 15 minuten of veel hevigere menstruatiebloedingen dan normaal.
Can I take Xarelto 20 in pregnancy?
No — crosses placenta; DOACs are contraindicated in pregnancy. Use LMWH.
Wat als ik een operatie nodig heb?
Inform the surgical team well in advance. Rivaroxaban stopped 24-48 hours before surgery depending on bleeding risk and renal function.
Where can I buy Xarelto 20 online?
You can buy Xarelto 20 (rivaroxaban 20 mg, 14-112 tablets) from MedsBase with discreet packaging and worldwide shipping.
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| Sterkte | 20 mg |
|---|---|
| Hoeveelheid | 14 Tablet/s, 28 Tablet/s, 42 Tablet/s, 56 Tablet/s, 112 Tablet/s |
Xarelto 20
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Xarelto 20
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