Medical Information

Rivaroxaban is an oral anticoagulant primarily used for the prevention and treatment of thrombotic diseases. Its indications include venous thromboembolism, non valvular atrial fibrillation, etc. When using medication, attention should be paid to the risk of bleeding, adjustments for special populations, and drug interactions. The following provides a detailed explanation from two aspects: indications and medication precautions.

1. Indications

(1) Prevention of venous thromboembolism: Used for patients after hip or knee replacement surgery to reduce the risk of deep vein thrombosis and pulmonary embolism.

(2) Deep vein thrombosis treatment: used for the treatment and recurrence prevention of acute deep vein thrombosis (DVT) and pulmonary embolism (PE).

(3) Non valvular atrial fibrillation: used to reduce the risk of stroke and systemic embolism in patients with non valvular atrial fibrillation.

2. Medication precautions

(1) Bleeding risk: Patients with active bleeding or high-risk bleeding are prohibited from using this medication. Bleeding signs should be monitored during medication, and severe bleeding should be stopped and anticoagulation should be reversed.

(2) Liver and kidney function: Patients with moderate to severe liver injury or CrCl<30mL/min are not allowed to use it, while patients with mild liver injury or CrCl 15-30mL/min need to adjust the dosage.

(3) Special populations: contraindicated during pregnancy (may cause fetal bleeding), use with caution during lactation; Elderly patients have an increased risk of bleeding and require close monitoring.

(4) Drug interactions: Avoid using potent CYP3A4/P-gp inhibitors (such as ketoconazole) or inducers (such as rifampicin) in combination, as they may affect drug efficacy.

(5) Surgical intervention: Medication should be discontinued 24-48 hours before elective surgery based on bleeding risk, and emergency surgery should assess the balance between bleeding and thrombus risk.