Xarelto (Rivaroxaban): Uses, Dosing, Side Effects & How It Works

Xarelto (rivaroxaban) is a direct oral anticoagulant (DOAC) that helps prevent harmful blood clots by selectively inhibiting Factor Xa. It is commonly used in atrial fibrillation (AF) to reduce stroke risk, and for the treatment and prevention of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE).

What Xarelto Is Used For

• Stroke/systemic embolism prevention in nonvalvular AF
• Treatment of DVT and PE
• Prevention of recurrent DVT/PE after initial therapy
• Post–hip or knee replacement prophylaxis to prevent clots
• In certain patients at cardiovascular risk, 2.5 mg plus aspirin may be considered per prescriber guidance

For full prescribing information, see the official Xarelto Product Monograph (Bayer).

 

Dosing (General Information)

Dosing is individualized by your prescriber based on your indication, kidney function, age, and other medicines. Always follow your prescription exactly. 15 mg and 20 mg doses are typically taken with food to improve absorption; other strengths may be taken with or without food as directed.

Missed dose: Take it when remembered the same day. If it’s close to your next dose, follow your prescriber’s instructions—do not double up unless you’ve been told to do so.

 

Available Doses of Xarelto (Rivaroxaban)

Xarelto is available in multiple strengths to suit different clinical needs. Your clinician will select the right dose for your situation.

• 2.5 mg tablets: Often used alongside aspirin in select cardiovascular patients (per prescriber guidance).
• 10 mg tablets: Common for VTE prevention after hip or knee replacement.
• 15 mg tablets: Used in AF or DVT/PE regimens; typically taken with food.
• 20 mg tablets: Often used for AF stroke prevention or ongoing DVT/PE therapy; typically taken with food.

 

Common Side Effects

As with all anticoagulants, Xarelto can increase bleeding risk. Frequently reported effects include:

• Easy bruising; gum or nosebleeds
• Prolonged bleeding from cuts
• Fatigue or weakness (possible anemia)
• Stomach upset in some patients

Seek urgent care for severe or uncontrollable bleeding, black/tarry stools, red/brown urine, coughing/vomiting blood, sudden severe headache, fainting, or stroke symptoms.

 

Who Should Not Take Xarelto

• Active pathological bleeding or conditions with high bleeding risk
• Severe liver disease with coagulopathy
• Allergy to rivaroxaban or any tablet component
• Use with certain strong combined CYP3A4 and P-gp inhibitors or inducers (e.g., ketoconazole, ritonavir, rifampin)—ask your prescriber

 

How Xarelto Works

Rivaroxaban selectively inhibits Factor Xa, a key step in the coagulation cascade. By limiting thrombin generation and clot formation, it helps prevent stroke in AF and treats/prevents VTE.

 

More Clinical Details

Pregnancy & Breastfeeding

Xarelto is not routinely recommended during pregnancy due to limited human data and bleeding risk. If anticoagulation is required during pregnancy, clinicians may consider low-molecular-weight heparin (LMWH). Because rivaroxaban may be present in breast milk, avoid use while breastfeeding unless your prescriber advises otherwise.

Drug, Food & Alcohol Interactions

• Medicines: NSAIDs, antiplatelets, other anticoagulants, and some antidepressants (SSRIs/SNRIs) can raise bleeding risk. Strong combined CYP3A4/P-gp inhibitors or inducers may affect levels—consult your clinician.
• Food: Take 15 mg and 20 mg with food; other strengths as directed.
• Alcohol: May increase bleeding risk—ask your prescriber about safe limits.

Monitoring & Procedures

Your prescriber may check kidney/liver function as appropriate. You may need to pause Xarelto before surgery or dental work—only under medical guidance.

 

Xarelto Alternatives & Generic Options

• Generic rivaroxaban (Xarelto): Same active ingredient; often lower cost.
• Eliquis (apixaban): Another Factor Xa inhibitor; some patients and clinicians prefer it in certain scenarios.
• Dabigatran (Pradaxa): Direct thrombin inhibitor in capsule form.
• Edoxaban (Savaysa): Oral Factor Xa inhibitor alternative.
• Warfarin: Effective, inexpensive option requiring INR monitoring and dietary vigilance.

 

Lower Your Cost (For U.S. Patients)

If Xarelto is too expensive locally, Americans can order brand Xarelto or generic rivaroxaban from Canada for personal use with a valid U.S. prescription. Current examples: $114.95 for 100 tablets generic rivaroxaban and $365 for 90 tablets brand Xarelto. Orders typically ship to U.S. residential addresses as a 90-day personal-use supply. Prices checked October 17, 2025.

Explore options & pricing: Xarelto / Rivaroxaban Product Page

 

How to Buy from Canada (Step-by-Step)

1. Get a valid U.S. prescription for Xarelto (rivaroxaban).
2. Send your prescription: Your clinic can fax to 1-833-209-3704 or you can upload your prescription.
3. Choose brand or generic: Select Xarelto or generic rivaroxaban and the correct tablet strength.
4. Consider a 3-month supply: Ordering more can reduce your per-tablet cost.
5. Shipping: Orders ship to U.S. residential addresses (typically within 1–2 weeks), up to a 90-day supply.

 

When to Seek Medical Help

• Severe or uncontrolled bleeding
• Signs of stroke (sudden weakness, facial droop, trouble speaking, severe headache)
• Black/tarry stools or red/brown urine
• Any unusual or concerning symptoms

 

References

Official monograph and full product information: Xarelto Product Monograph (Bayer).

Disclaimer: This page is for educational purposes and does not replace medical advice. Always consult your healthcare provider before starting or changing medications.

Ready to order? Start here: Buy Xarelto / Rivaroxaban from Canada

Legal and Safety Information

Information on this page is provided for general educational purposes and should not replace advice from a licensed healthcare professional. Some U.S. patients choose to source medications like Xarelto or generic rivaroxaban through licensed Canadian prescription referral services to help reduce costs. Medications dispensed by Canadian pharmacies are Health Canada–approved and intended for personal use only. Always follow your prescriber’s instructions and consult your healthcare provider with any questions about your treatment.

Xarelto can be taken with or without food, but the 15 mg and 20 mg tablets should be taken with food. Consistency in the timing of the medication each day is important for maintaining its effectiveness. Do not stop taking Xarelto without consulting your healthcare provider, as this may increase the risk of blood clots.