Each day, people like you search online for answers to questions about knee or hip replacement surgery and XARELTO®. So we wanted to take this opportunity to answer some of them. Below, you’ll find answers to the questions people ask the most.
Knee and hip surgery FAQs
If you’ve had knee or hip replacement surgery, you’re at greater risk for blood clots in your deep veins, like those in your legs (deep vein thrombosis, or DVT) and in your lungs (pulmonary embolism, or PE). XARELTO® is a prescription blood thinner that helps reduce the risk of DVT and PE blood clots after knee or hip replacement surgery. XARELTO® works by blocking Factor Xa (“10a”), an enzyme needed for blood to clot.
Most people who have hip replacement surgery will take XARELTO® 10 mg once a day for 35 days following surgery. Those who have knee replacement surgery will usually take 10 mg once a day for 12 days. However, only your healthcare professional can decide how long you should take XARELTO®. Do not stop taking XARELTO® without talking to the healthcare professional who prescribes it for you. Stopping XARELTO® increases your risk of having a blood clot.
To reduce your risk of blood clots in the legs and lungs following knee or hip replacement surgery, you should take XARELTO® 10 mg once a day with or without food. If you miss a dose of XARELTO®, take it as soon as you remember on the same day. Take your next dose at your regularly scheduled time.
XARELTO® is a prescription blood thinner that helps reduce the risk of DVT and PE blood clots in the legs and lungs after knee or hip replacement surgery. Learn more.
XARELTO® lowers your blood’s ability to clot by selectively blocking one of the clotting factors found in your blood—an enzyme called Factor Xa (“10a”). Learn more.
It has been shown that the effect of XARELTO® on your body’s blood-clotting function is the same regardless of age, race, weight, sex, or dietary changes. There are also limited known interactions between XARELTO® and other medications.
If you take XARELTO®, regular blood tests are not needed to see if XARELTO® is working, to check your blood-thinning levels (international normalized ratio, or INR), or to change your medication dose.*
*Certain patients with impaired kidney function may be monitored by their healthcare professional and have their dose adjusted as necessary.
XARELTO® has fewer drug interactions than older medicines like warfarin. Not only does warfarin interact with other medicines, alcohol, and certain foods (especially those high in vitamin K, like leafy greens), but the initial dosing of warfarin varies widely from person to person based on a number of factors, including age, race, weight, and sex. Because of this, when taking warfarin, you will need to have regular blood tests—in some cases as often as 1 or 2 times a week—to ensure your warfarin dose remains safe and effective.
You should always tell your healthcare professional about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements—especially if you take ketoconazole, ritonavir, erythromycin, carbamazepine, phenytoin, rifampin, or St. John’s wort.
Unlike warfarin (Coumadin®), XARELTO® has no known dietary restrictions. You do not have to adjust your intake of leafy greens and other foods high in vitamin K, as they don't affect how XARELTO® works.
Under the supervision of your healthcare professional, like other prescription medicines, XARELTO® may be taken with other medications. Always tell your healthcare professional about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements—especially if you take ketoconazole, ritonavir, carbamazepine, phenytoin, rifampin, erythromycin, or St. John’s wort.
It’s also important to note that, as with all blood thinners, you have a higher risk of bleeding if you take XARELTO® with other medicines that also increase your risk of bleeding, such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), warfarin, any medicine that contains heparin, clopidogrel (Plavix®️), selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), or other medicines to prevent or treat blood clots.
Like all blood thinners, XARELTO® can cause bleeding, which can be serious, and in rare cases, can be life threatening. Be sure to take XARELTO® exactly as prescribed, and do not stop taking XARELTO® without talking to the healthcare professional who prescribes it for you. You should discuss all potential benefits and risks with your healthcare professional.
The list price of XARELTO® is $516 per month, but most patients pay between $0 and $47 per month.1,2 But remember, how much you will have to pay for XARELTO® depends on your health plan coverage. If you have commercial or private insurance and are being treated with XARELTO®, except if you are only taking XARELTO® 10 mg after a recent non-surgical hospitalization or because you have recently undergone knee or hip replacement surgery, you may be eligible for savings through the Janssen CarePath Savings Program for XARELTO®.
If you have government insurance, or no prescription coverage, Janssen CarePath can provide information about other resources that may be able to help with your out-of-pocket medication costs. Learn more about your savings options.
1. Actual out-of-pocket costs may vary based on dosing, indication, site of care, insurance coverage, and your eligibility for support programs. Contact your insurance provider for more details on your individual plan. List price may vary based on dosing and indication. List price does not include induction doses, the cost of giving you a dose, or pharmacy fees.
2. Approximately 75% of US patients pay between $0 and $47 per month. Out-of-pocket cost estimates are based on approved pharmacy claims, normalized to a 30-day supply, after application of insurance benefits. Costs do not include medical claims, induction doses, or starter kits. Note: This is based on information licensed from IQVIA®: IQVIA® Out of Pocket Cost (OPC Tool) for the period January 2021–December 2021, reflecting estimates of real-world activity.
There is no XARELTO® coupon. How much you will have to pay for XARELTO® depends on your health plan coverage. We can also provide information on other resources that may help you save on XARELTO®.
Visit JanssenCarePath.com for information on affordability programs and independent foundations† that may have funding available to help you with medication costs for XARELTO®.
†Independent co-pay assistance foundations have their own rules for eligibility. We cannot guarantee a foundation will help you. We only can refer you to a foundation that supports your disease state. This information is provided as a resource for you. We do not endorse any particular foundation.
When starting XARELTO®, it takes 2–4 hours for it to reach its full blood-thinning effect, and it leaves your system more quickly than warfarin—typically in about 24 hours. Compared to warfarin, which can take 3–4 days to reach its full blood-thinning effect and up to 7 days to leave your system, XARELTO® may be an option for people who plan to have surgery or surgical dental procedures.
XARELTO® was developed together by Janssen and Bayer. They continue to develop XARELTO® to treat and help reduce the risk of blood clot–related events in different conditions.