Each day, people like you search online for answers to questions about pulmonary embolism (PE) 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.
XARELTO® is a prescription blood thinner that stops existing clots from growing larger and helps prevent new ones from forming. It works by blocking Factor Xa (“10a”), an enzyme needed for blood to clot.
If you’ve had a PE blood clot, you’re at greater risk of having another. For people who have an ongoing risk for PE blood clots after completing at least six months of initial treatment, XARELTO® helps reduce the risk of future events. XARELTO® works by blocking Factor Xa (“10a”), an enzyme needed for blood to clot.
Because you’re more likely to have another PE in the first three weeks after your initial event, XARELTO® 15 mg is taken twice a day with food for the first 21 days of treatment to make sure there is enough medicine in your system during the period of highest risk. After 21 days, the risk of having another PE is lower, so the dosage of XARELTO® is reduced to 20 mg once-daily with food starting on day 22.
You should take XARELTO® exactly as prescribed by your healthcare professional. Do not change your dose or stop taking XARELTO® unless your healthcare professional tells you to.
Taking steps to be healthier and reduce your risk is an important part of preventing future blood clots. But since having a prior PE increases your risk of having another blood clot, it’s very important that you take XARELTO® exactly as your healthcare professional prescribes. Do not stop taking XARELTO® without talking to the healthcare professional who prescribes it for you.
To reduce your risk of another PE blood clot, you should take XARELTO® with food at the same time each day.
If you take XARELTO® twice a day and miss a dose, take it as soon as you remember on the same day. You may take 2 doses at the same time to make up for the missed dose. Take your next dose at your regularly scheduled time.
If you take XARELTO® once a day and miss a dose, take it as soon as you remember on the same day. Take your next dose at your regularly scheduled time.
Long flights increase the risk of getting a DVT blood clot because a lack of mobility for long periods—like hours spent sitting in a cramped airplane seat—can lead to slow blood flow. When this happens, your blood is prevented from mixing with the naturally occurring substances that keep it from clotting. A DVT blood clot may form and can move from your legs to your lungs, causing a PE. To avoid getting a blood clot, it’s important to get up and move around every so often. At the very least, change position in your seat and flex your feet and calves to encourage blood flow. If you have other risk factors for blood clots and will be traveling, ask your doctor how a blood thinner like XARELTO® may help.
XARELTO® is a prescription blood thinner that treats and helps reduce the risk of another DVT or PE. 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. 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 coverage, 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.
Savings are available to eligible patients through the Janssen CarePath Savings Program for XARELTO®. 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.
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.
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 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 in emergency situations under the direction of a healthcare provider. 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.