Xarelto
It is the brand name of a drug called rivaroxaban, which belongs to the family of drugs called anticoagulants. This type of medication prevents harmful blood clots from forming in the blood vessels by reducing the capacity of the blood to clot.
The active substance in the medication is a ”factor Xa inhibitor.” This actually means that it blocks factor Xa, an enzyme in the body that helps in the production of thrombin – an enzyme that is vital to the process of blood clotting.
It was originally approved by the US Food and Drug Administration in 2011.
Uses
This medication is typically used to prevent or treat deep vein thrombosis, a condition that can lead to blood clots in the lungs. Deep vein thrombosis can occur if you have certain medical problems which affect how your blood clots.
Moreover, this medication is used in patients with atrial fibrillation (a heart rhythm disorder of the upper chambers of the heart with symptoms such as fainting, dizziness, fatigue, weakness, and shortness of breath) to lower the risk of stroke caused by a blood clot.
An estimated 6 percent of people in the United States over the age of 60 have atrial fibrillation, raising their risk of blood clots considerably, ultimately leading to stroke. This serious condition can be detected by feeling the pulse at the wrist. If you are in atrial fibrillation, the pulse will feel irregular and beats may vary in strength.
Dosage
The usual recommended dose is 10 mg once per day. This medication is available as tablets (2.5, 10, 15, and 20 mg).
Note – do not give this anticoagulant to anyone else, even if they have similar symptoms as you do.
Side Effects And Precautions Of Rivaroxaban
Common side effects may include:
- itching;
- pain in the arms or legs;
- muscle pain.
Rare side effects may include:
- a feeling like you might pass out;
- easy bruising or bleeding (bleeding gums, nosebleeds, heavy menstrual bleeding);
- weakness;
- coughing up blood or vomit which looks like coffee grounds;
- urine which looks pink, red, or brown;
- dizziness;
- bleeding that will not stop;
- headaches;
- bloody or tarry stools;
- an allergic reaction, with symptoms including – rash, hives, shortness of breath, itching, cough, wheezing, or swelling of face, tongue, lips, or throat.
To be sure that this medication is safe for you, tell your healthcare provider:
- if you have had a heart valve replaced;
- if you have an allergy to any ingredient of the medication;
- if you have kidney disease;
- if you have bleeding problems;
- if you have liver disease;
- if you are breastfeeding or plan to breastfeed;
- if you are pregnant or plan to get pregnant;
- if you are taking St. John’s Wort;
- if you are taking any natural products, prescription or over-the-counter medicines as well as certain drugs which are used for infections, HIV/AIDS, or seizures;
- if you are allergic to any type of medication, foods, or other substances.
Warfarin
It is the generic name of two brand medications called Jantoven or Coumadin. It is a type of medicine called an oral anticoagulant.
It was first approved by the US FDA in June 1954.
Uses
This medication is typically used to treat or prevent blood clots in arteries or veins, that can reduce the risk of heart attack, stroke (happens when blood flow to your brain stops), or other life-threatening conditions.
In addition, treatment with this medication is the cornerstone in the prevention of thromboembolism in sufferers with atrial fibrillation. According to the data, this anticoagulant reduces the risk of stroke by 66 percent in comparison with no anticoagulation.
Note – therapy with this medication is not recommended for atrial fibrillation patients with no underlying heart disease. Nevertheless, in people with a history of transient ischemic attack or prior stroke, or in patients with prosthetic heart valves the use of this anticoagulant is likely to be beneficial overall.
Dosage
The usual recommended initial dose for the prevention of thromboembolism in atrial fibrillation is 2 to 5 mg orally once per day. The usual maintenance dosage is 2 to 10 mg orally once per day.
Target INR (International normalized ratio) is 2.5 (range: 2 to 3).
Important note – patients taking this anticoagulant are required to have a regular blood test called INR. It measures the time it takes your blood to clot.
Side Effects And Precautions
Side effects may include:
- bleeding between menstrual periods;
- bleeding from the gums after you brush your teeth;
- fever (high temperature);
- black or bloody stool;
- inability to eat for more than 24 hours;
- vomiting material that looks like coffee grounds;
- diarrhea.
Rare side effects may include:
- weakness;
- severe bleeding, including heavier than normal menstrual bleeding;
- vision changes;
- coughing up blood;
- stomach pain;
- red urine;
- dizziness;
- severe headaches;
- bruising which develops without an injury you remember;
- joint pain, swelling or discomfort, particularly after an injury.
Pregnancy
Because this medication may cause miscarriage, congenital disabilities, or death of the unborn baby, do not take this anticoagulant if you are pregnant unless you have a mechanical heart valve. In addition, do not use the medication if you are breastfeeding.
Xarelto vs Warfarin – Which Is Better For Atrial Fibrillation?
Anticoagulant medications are the mainstay therapy for the prevention and treatment of venous thromboembolism and for stroke prevention in people with non-valvular atrial fibrillation.
According to a September 8, 2011, study that examined the effectiveness of these anticoagulants in people with atrial fibrillation, there were no significant differences in the risk of significant bleeding, however, intracranial and fatal bleeding occurred less frequently in people taking rivaroxaban.
Additionally, a few recent scientific studies conclusively established that new anticoagulants (like rivaroxaban) have a lower risk of spontaneous bleeding when compared to Jantoven or Coumadin, making them potentially safer from that perspective.
Note – rivaroxaban doesn’t negatively interact with as many types of food as other anticoagulants like warfarin.
Image credit – Shutterstock
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References https://www.jnj.com/media-center/press-releases/new-xarelto-rivaroxaban-data- https://www.xareltohcp.com/clinical-trials/nonvalvular-atrial-fibrillation.html https://www.medscape.com/viewarticle/884743