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Frequently Asked Questions | XARELTO® (rivaroxaban)

Answering Your Questions

Each day, people like you search online for answers to questions about 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.


XARELTO® is a blood thinner that treats and helps prevent blood clots that are related to certain conditions involving the heart and blood vessels.

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.

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.*

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.

*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.

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 register 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, 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 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.