Answering Your Surgery Questions

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 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® FAQs

XARELTO® is a prescription blood thinner that helps reduce the risk of DVT and PE blood clots 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.

Unlike warfarin, 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.*

Not only does warfarin interact with other medicines, alcohol, and certain foods (especially those high in vitamin K), 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, you will need to have regular blood tests—in some cases as often as 1–2 times a week—to ensure your warfarin dose remains safe and effective.

*Certain patients with impaired kidney function may be monitored by their healthcare professional and have their dose adjusted as necessary.

Unlike warfarin (Coumadin®), XARELTO® has no known dietary restrictions. You can still enjoy eating leafy greens and other foods high in vitamin K without affecting how XARELTO® works.

XARELTO® has fewer drug interactions than older medicines like warfarin, but 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, 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, or clopidogrel.

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.

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 JanssenPrescriptionAssistance.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 have no control over these independent foundations and can only refer you to a foundation that supports your disease state. We do not endorse any particular foundation.

Other Resources

The Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is an independent, nonprofit organization that is committed to helping eligible patients without insurance coverage receive prescription products donated by Johnson & Johnson operating companies. To see if you might qualify for assistance, please contact a JJPAF program specialist at 1‐800‐652‐6227 (Monday–Friday, 9:00 AM to 6:00 PM ET) or visit the foundation website at www.JJPAF.org.

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 JanssenPrescriptionAssistance.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 have no control over these independent foundations and can only refer you to a foundation that supports your disease state. We do not endorse any particular foundation.

Other Resources

The Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is an independent, nonprofit organization that is committed to helping eligible patients without insurance coverage receive prescription products donated by Johnson & Johnson operating companies. To see if you might qualify for assistance, please contact a JJPAF program specialist at 1‐800‐652‐6227 (Monday–Friday, 9:00 AM to 6:00 PM ET) or visit the foundation website at www.JJPAF.org.

Do everything you can to fill your prescription before you run out. Skipping or stopping XARELTO® may increase your risk of having a DVT or PE blood clot or stroke. If you’ve been prescribed XARELTO®, you can set up monthly refill reminders when you regiser for Janssen CarePath, which offers support and educational resources for people taking XARELTO®.

If you need to have surgery or surgical dental procedures, be sure to tell your surgeon, dentist, oral surgeon, or other healthcare professionals that you are taking XARELTO®. You should also talk to the healthcare professional who prescribed XARELTO® for you. Only they can tell you whether, and for how long, you may need to stop. If you do need to stop taking XARELTO®, it is typically stopped at least 24 hours before your procedure.

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 a more convenient option for people who plan to have surgery or surgical dental procedures.

An agent to reverse the anti-factor Xa activity of XARELTO® is available. XARELTO® starts and stops working relatively quickly, which can help your healthcare professional manage your treatment if you plan to have surgery or surgical dental procedures. Do not stop taking XARELTO® without talking to the healthcare professional who prescribes it for you.

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.