What should I know about Xarelto before taking it?

Before you start taking Xarelto (rivaroxaban), keep in mind that while it can normally be taken with or without food, in high doses it may be better taken with food, so if your doctor prescribes a high dose you may want to plan to take Xarelto around meals.
Also be aware that some conditions can be complicated by taking Xarelto (a blood-thinning drug prescribed to reduce the risk of stroke in people with a heart rhythm disorder as well as to reduce the risk of blood clots after knee or hip replacement surgery). These conditions include:
  • any tendency for abnormal bleeding or a condition that causes you to bleed easily
  • atrial fibrillation, a heart rhythm disorder
  • a liver or kidney problem
  • an allergy to rivaroxaban

Let your doctor know if you have any of these conditions. You should also know that Xarelto may not be advisable if you have to have surgery that will require spinal anesthesia, such as an epidural, or you need to undergo a diagnostic test that involves placing a needle into your spinal column, such as a spinal tap. Tell your doctor if you're pregnant, plan to become pregnant or if you're nursing a baby.

Be aware that Xarelto cannot be taken with other prescription blood thinners, such as warfarin (Coumadin), or with over-the-counter ones, such as aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs). Many drugs interact dangerously with Xarelto, including some common ones such as ketoconazole, erythromycin and St. John's wort. Give your doctor a list of all the medications you take to review for possible interactions with Xarelto. This list should include prescription and nonprescription drugs, herbal remedies and supplements.

Finally, do not stop taking Xarelto without talking to your doctor. You will need an alternate treatment to prevent dangerous blood clotting.