FDA Approves Xarelto (rivaroxaban) for multiple indications including stroke prevention in nonvalvular atrial fibrillation and treatment of VTE.
The FDA has approved rivaroxaban (Xarelto), a factor Xa inhibitor, for a broad range of thromboembolic indications. Key approved uses include reducing the risk of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation, treating deep vein thrombosis (DVT) and pulmonary embolism (PE), and reducing the risk of recurrence of DVT and/or PE after initial treatment. For clinicians, this approval provides an oral anticoagulant option across several patient populations, including for prophylaxis in orthopedic surgery and acutely ill medical patients, as well as for reducing major cardiovascular events in coronary artery disease and peripheral artery disease when combined with aspirin. The label specifies dosing varies by indication and includes renal considerations, particularly for atrial fibrillation.
+ Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
XARELTO is a factor Xa inhibitor.
XARELTO is indicated: to reduce risk of stroke and systemic embolism in nonvalvular atrial fibrillation; for treatment of DVT; for treatment of PE; for reduction in the risk of recurrence of DVT or PE; for the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery; for prophylaxis of VTE in acutely ill medical patients at risk for thromboembolic complications not at high risk of bleeding; to reduce the risk of major cardiovascular events in patients with CAD, in combination with aspirin; to reduce the risk of major thrombotic vascular events in patients with PAD, including patients after recent lower extremity revascularization due to symptomatic PAD, in combination with aspirin; for treatment of VTE and reduction in the risk of recurrent VTE in pediatric patients from birth to less than 18 years; for thromboprophylaxis in pediatric patients 2 years and older with congenital heart disease after the Fontan procedure.
For nonvalvular atrial fibrillation: 15 or 20 mg once daily with food (use 20 mg once daily with evening meal if CrCl >50 mL/min; CrCl ≤50 mL/min requires consideration as patients with CrCl <30 mL/min were not studied). For treatment of DVT and/or PE: 15 mg orally twice daily with food for the first 21 days followed by 20 mg orally once daily with food. For reduction in the risk of recurrence of DVT and/or PE: 10 mg once daily with or without food, after at least 6 months of standard anticoagulant treatment. For prophylaxis of DVT following hip or knee replacement surgery: 10 mg orally once daily with or without food. For prophylaxis of VTE in acutely ill medical patients: 10 mg once daily, with or without food, in hospital and after discharge for a total recommended duration of 31 to 39 days. For CAD or PAD: 2.5 mg orally twice daily with or without food, in combination with aspirin (75–100 mg) once daily. Pediatric dosing: See Full Prescribing Information.
Trial data not available in label.
Not reported in label.
Not reported in label.