Noval anticoagulants - rivaroxaban Flashcards
1
Q
What is the generic name of rivaroxaban?
A
Xarelto
2
Q
What is the method of action of rivaroxaban?
A
- Inhibits free and bound factor 10a
* Highly selective direct factor Xa inhibitor
3
Q
What are the indications of rivaroxaban?
A
• Prevention of clots after elective hip/knee surgery
4
Q
What are the contraindications of rivaroxaban?
A
- Excessive bleeding
- Condition that puts you at a high risk of bleeding e.g. stomach ulcers, surgery of the brain/eyes
- Hepatic disease associated with coagulopathy and clinically relevant bleeding risk
- Pregnant/breastfeeding
- Renal disease – take special care
- Severe hypertension - take special care Retinopathy - take special care
- Bronchiectasis/bleeding from lungs - take special care
5
Q
What are the side effects of rivaroxaban?
A
- Bleeding – stomach, eyes, bruising
- Pain in limbs
- Fever
- Anaemia
- GI upset
- Hypotension = dizziness
- Fatigue
- Rash/itchy skin
- Kidney impairment
6
Q
What are the interactions with rivaroxaban?
A
- Anticoagulants/anti-platelets - ↑ bleeding risk
- NSAIDs - ↑ bleeding risk
- Azoles – strong inhibitor of CYP3A4 so ↑ concentration
- Anti-viral - ↑ bleeding risk
- Dronedarone (for abnormal heart beat) - ↑ bleeding risk
- Epilepsy medication e.g. phenytoin - ↑ clot risk
- St John’s Wort - ↑ clot risk
- Rifampicin - ↑ clot risk
7
Q
What organs eliminate rivaroxaban?
A
• Renal (52%) and faecal (43%)
8
Q
What patient information should be given to those taking rivaroxaban?
A
• May make you dizzy – if this occurs you should not drive/use machinery
