Novel anticoagulants - Rivaroxaban

Question 1

How does rivaroxaban work?

Answer 1

Rivaroxaban is a direct inhibitor of Factor Xa. This inhibits the final clotting cascade.

Question 2

What is rivaroxaban used for?

Answer 2

• prophylaxis of VTE in adults after hip or knee replacement.
• prevent recurrence or extending of clot in VTE.
• prophylaxis of stroke in patients with atrial fibrillation and one of (CCF, Hypertension, previous stroke or TIA, 75yrs+, diabetes)

Question 3

How is rivaroxaban used to treat used to prevent atherothrombotic events following an ACS?

Answer 3

low dose rivaroxaban with aspirin alone (or aspirin and clopidogrel)

Question 4

how is rivaroxaban monitored?

Answer 4

Rivaroxaban doesn’t need regular monitoring and INR is unreliable for it.

Question 5

What are the side effects of rivaroxaban?

Answer 5

• nausea

- haemorrhage

Question 6

what are the warnings of rivaroxaban use?

Answer 6

• bleeding risk
• sever hypertension
• avoid in liver disease with coagulopathy

Question 7

what are the drug interaction of rivaroxaban ?

Answer 7

The following cytochrome P450 inducers reduce the concentration of rivaroxaban:

• carbamezapine
• phenytoin
• rifampicin