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| HIGHLIGHTS OF PRESCRIBING INFORMATION
These highlights do not include all the information needed to use XARELTO® (rivaroxaban) safely and effectively. See full prescribing information for XARELTO.
XARELTO (rivaroxaban) tablets, for oral use
| Mechanism of Action
XARELTO is an orally bioavailable factor Xa inhibitor that selectively blocks the active site of factor Xa and does not require a cofactor (such as Anti-thrombin III) for activity. Activation of factor X to factor Xa (FXa) via the intrinsic and extrinsic pathways plays a central role in the cascade of blood coagulation.
| INDICATIONS AND USAGE
XARELTO is a factor Xa inhibitor indicated:
(1) to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
(2) for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) in patients undergoing knee or hip replacement surgery
USE IN SPECIFIC POPULATIONS
Active pathological bleeding
Severe hypersensitivity reaction to XARELTO
| WARNINGS AND PRECAUTIONS
Risk of bleeding: XARELTO can cause serious and fatal bleeding. Promptly evaluate signs and symptoms of blood loss.
Pregnancy related hemorrhage: Use XARELTO with caution in pregnant women due to the potential for obstetric hemorrhage and/or emergent delivery. Promptly evaluate signs and symptoms of blood loss.
| ADVERSE REACTIONS
The most common adverse reaction (>5%) was bleeding.
To report SUSPECTED ADVERSE REACTIONS, contact Janssen Pharmaceuticals, Inc. at 1-800-526-7736 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
| DOSAGE AND ADMINISTRATION
2.1 Nonvalvular Atrial Fibrillation
For patients with creatinine clearance (CrCl) >50 mL/min, the recommended dose of XARELTO is 20 mg taken orally once daily with the evening meal. For patients with CrCl 15 to 50 mL/min, the recommended dose is 15 mg once daily with the evening meal [see package insert for Use in Specific Populations (8.7)].
Switching from or to Warfarin - When switching patients from warfarin to XARELTO, discontinue warfarin and start XARELTO as soon as the International Normalized Ratio (INR) is below 3.0 to avoid periods of inadequate anticoagulation.
No clinical trial data are available to guide converting patients from XARELTO to warfarin. XARELTO affects INR, so INR measurements made during co-administration with warfarin may not be useful for determining the appropriate dose of warfarin. One approach is to discontinue XARELTO and begin both a parenteral anticoagulant and warfarin at the time the next dose of XARELTO would have been taken.
Switching from or to Anticoagulants other than Warfarin - For patients currently receiving an anticoagulant other than warfarin, start XARELTO 0 to 2 hours prior to the next scheduled evening administration of the drug (e.g., low molecular weight heparin or non-warfarin oral anticoagulant) and omit administration of the other anticoagulant. For unfractionated heparin being administered by continuous infusion, stop the infusion and start XARELTO at the same time.
For patients currently taking XARELTO and transitioning to an anticoagulant with rapid onset, discontinue XARELTO and give the first dose of the other anticoagulant (oral or parenteral) at the time that the next XARELTO dose would have been taken.
2.2 Prophylaxis of Deep Vein Thrombosis
-For patients undergoing hip replacement surgery, treatment duration of 35 days is recommended.
2.3 General Dosing Instructions
Prophylaxis of Deep Vein Thrombosis:
Surgery and Intervention:
Use with P-gp and Strong CYP3A4 Inhibitors or Inducers:
Avoid concomitant use of XARELTO with drugs that are combined P-gp and strong CYP3A4 inducers (e.g., carbamazepine, phenytoin, rifampin, St. John's wort)
| HOW SUPPLIED/STORAGE AND HANDLING
XARELTO (rivaroxaban) Tablets are available in the strengths and packages listed below:
10 mg tablets are round, light red, biconvex film-coated tablets marked with a triangle pointing down above a "10" on one side, and an "Xa" on the other side. The tablets are supplied in the packages listed:
15 mg tablets are round, red, biconvex film-coated tablets with a triangle pointing down above a "15" marked on one side and "Xa" on the other side. The tablets are supplied in the packages listed:
20 mg tablets are triangle-shaped, dark red film-coated tablets with a triangle pointing down above a "20" marked on one side and "Xa" on the other side. The tablets are supplied in the packages listed:
Store at 25° C (77° F) or room temperature; excursions permitted to 15°–30° C (59°–86° F) [see USP Controlled Room Temperature].
Keep out of the reach of children.
| Package Insert data:
Issued: November 2011
This Medication Guide has been approved by the U.S. Food and Drug Administration.
Finished Product Manufactured by:
© Janssen Pharmaceuticals, Inc. 2011
Trademarks are property of their respective owners.
PRINCIPAL DISPLAY PANEL - 10 mg Tablet Bottle Label
National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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