Commonly Rx Drugs - Rivaroxaban Flashcards
What does MHRA/CHM advise regarding the use Rivaroxaban? (3)
Not used for thromboprophylaxis in px with prosthetic heart valves.
High risk of recurrent thrombotic events in px with antiphospholid syndrome.
- DOACs not recommended in px with antiphospholipid syndrome, high risk patients who are tested positive for all 3 antiphospholipid tests - lupus anticoagulant, anticardiolipin ABx and anti-beta2 glycoprotein I ABx.
- Continued tx should be reviewed in these px to determine if appropriate to switch to a Vitamin k antagonist e.g. Warfarin.
Rivaroxaban 15mg and 20mg tablets taken with food:
- For px with difficulty swallowing, tablets can be crushed and mixed with water or apple purée immediately before and followed by food immediately after ingestion.
Dose adjustment in px with renal impairment:
- HCPs are reminded that:
- DOAC exposure is increased in px with renal impairment and these px to receive appropriate dosing.
- Px are reviewed regularly during tx to ensure dose remains appropriate.
- Renal function assessed by calculating CrCl using the Cockcroft and Gault formula.
What is the indication of Rivaroxaban? (1)
All px with prosthetic mechanical heart values need life ling oral anticoagulation with a Vitamin K antagonist i.e. warfarin as these values predispose the px to systemic embolism.
