Rivaroxaban

Say it: riv-uh-ROX-uh-ban · Brand names: Xarelto

Rivaroxaban is a blood thinner pill that helps prevent and treat harmful blood clots.

What it is

Your blood has proteins that help it clot. Rivaroxaban blocks one of these proteins, called factor Xa. This makes it harder for dangerous clots to form or grow.

Often used for

• treating blood clots in the legs or lungs
• lowering the chance that blood clots come back
• lowering the chance of stroke in people with an irregular heartbeat called atrial fibrillation
• preventing clots after hip or knee replacement surgery
• preventing clots in people in the hospital for a serious illness
• lowering the risk of heart attack and stroke in some people with heart or leg artery disease
• blood clots in children

How you get it

It is a pill you take by mouth, once or twice a day. Some strengths must be taken with food so your body absorbs them well. A liquid form is made for children. Your schedule may be different.

Common side effects and what helps

• Bruising more easily. Use a soft toothbrush and an electric razor.
• Small bleeding, like from your gums or nose. Press firmly for 10 minutes. Call if it does not stop.
• Heavier periods. Tell your team if your periods change.
• Back pain or belly pain. Tell your team if it is new or strong.
• Feeling dizzy. Stand up slowly.

Call your care team right away if you have

• Bleeding that will not stop, such as a nosebleed or a cut that keeps bleeding
• Red, pink, or dark brown urine
• Red or black stools that look like tar
• Coughing up blood, or throwing up blood or something that looks like coffee grounds
• A sudden bad headache, confusion, weakness, or trouble seeing or speaking
• A fall or a hit to the head, even if you feel fine

Before you start, tell your team

• If you have ever had bleeding problems, stomach ulcers, or a stroke
• If you have kidney or liver problems
• All medicines, vitamins, and herbs you take, especially aspirin, ibuprofen, naproxen, other blood thinners, and fish oil
• If you are pregnant, may become pregnant, or are breastfeeding
• If you have a surgery, dental work, or a procedure planned
• If you have a mechanical heart valve or a condition called antiphospholipid syndrome

Good to know

• Stopping this medicine too soon raises the chance of a clot or stroke. Do not stop it unless your care team tells you to.
• If you get a spinal tap or a numbing shot in the back (epidural), there is a rare risk of bleeding near the spine that can cause lasting weakness. Tell your team you take this medicine.
• Some medicines and herbs, like St. John's wort and some antifungal or seizure medicines, can change how rivaroxaban works.
• You may have blood tests to check your kidneys, liver, and blood counts.

At home

• Ask your team if your dose should be taken with food. The larger strengths should be taken with a meal.
• Take it at the same time each day.
• If you cannot swallow pills, ask your team. The tablet can be crushed and mixed with applesauce.
• If you miss a dose, ask your team what to do. Do not take extra to catch up unless they tell you to.
• Store it at room temperature, away from children. Refill it before you run out.

Questions to ask

• Do I need to take my dose with food?
• How long will I need this medicine?
• What should I do if I miss a dose?
• What should I do before surgery or dental work?

Side effect guides

• Low platelets and bleeding
• Pain

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.