What Members Say

These insights are based on 194 comments about Xarelto from MyHeartDiseaseTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

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How Xarelto Works and How It’s Taken

Xarelto is a type of anticoagulant, or blood thinner, that blocks factor Xa, a protein that helps blood clot. This reduces the production of thrombin, a substance that helps form blood clots.

Doctors prescribe Xarelto when certain heart or blood vessel conditions raise the risk of blood clot-related problems:

• Atrial fibrillation (AFib) — In adults with AFib not caused by a heart valve problem, Xarelto lowers the risk of stroke and blood clots traveling to other parts of the body.
• Coronary artery disease (CAD) — In adults, Xarelto lowers the risk of heart attack, stroke, and death from heart-related causes when taken with aspirin.
• Peripheral artery disease (PAD) — In adults, Xarelto lowers the risk of serious blood clot-related problems, including heart attack, stroke, and major amputation due to poor blood flow, when taken with aspirin.
• Congenital heart disease in children — Xarelto helps prevent blood clots in children ages 2 and older who have undergone the Fontan procedure, a type of heart surgery.

Xarelto comes as tablets and an oral liquid. The dose and how often it is taken depend on the condition being treated.

Typical Dosing for Heart-Related Conditions

• Atrial fibrillation — Adults typically take 20 milligrams once daily with the evening meal. Those with reduced kidney function may need 15 milligrams once daily with the evening meal, depending on their kidney function.
• Coronary artery disease — Adults take 2.5 milligrams twice daily, with or without food, along with aspirin 75 to 100 milligrams once daily to lower the risk of serious heart problems, including heart attack and stroke.
• Peripheral artery disease — Adults take 2.5 milligrams twice daily, with or without food, along with aspirin 75 to 100 milligrams once daily to lower the risk of serious blood clot-related problems.
• Congenital heart disease after the Fontan procedure — Children ages 2 and older receive a dose based on their body weight. Xarelto may be given once or twice daily, with or without food, depending on their weight.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

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Top Advice From Members on Xarelto

The advice below draws on 194 comments about Xarelto from MyHeartDiseaseTeam members. It reflects individual experiences, not medical advice.

Members who use Xarelto often talk about balancing stroke prevention with day-to-day issues like bleeding, side effects, cost, and scheduling procedures. Many say it helps to stay in close contact with your cardiology team, notice how you feel after starting or switching, and plan ahead for meals, refills, and appointments.

1. 1
   Watch for bleeding and tell your doctor about it.
   “But I recently had a nosebleed that had me in ER for six hours before stopping the bleed. I lost a pint of blood and was almost admitted to the hospital.”
2. 2
   Talk to your doctor before procedures or dental work.
   “Need to have cataract surgery and soon need to have all my teeth extracted. Have been anxious about coming off of the blood thinners to have these procedures done.”
3. 3
   Ask about cost help if Xarelto is hard to afford.
   “I’m already on Xarelto and that would cost me $600/month, but my doctor was able to get on a program through Janssen for $85/month.”

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Xarelto Side Effects

In clinical studies of Xarelto, the most common side effects occurred in about 5 percent to 36 percent of people taking the medication. The risk varied depending on the condition being treated and the study population.

Side effects in adults include:

• Bleeding, such as bruising more easily or bleeding that takes longer to stop

Side effects in children include:

• Bleeding
• Cough
• Vomiting
• Gastroenteritis (stomach flu, an inflammation of the stomach and intestines)

Serious Side Effects and Warnings

Xarelto can cause serious side effects that may require immediate medical attention. These include:

• Serious bleeding — Bleeding may be severe, happen in any organ, and be fatal.
• Blood clots after stopping Xarelto too soon — Stopping treatment can increase the risk of blood clots, including stroke.
• Spinal or epidural hematoma — A blood clot near the spine can cause long-term or permanent paralysis, especially after spinal anesthesia or a spinal puncture.
• Severe allergic reaction — Hypersensitivity reactions, including anaphylaxis, may occur.

Xarelto has a boxed warning, the FDA’s strongest safety warning, for some of these serious risks. A boxed warning does not mean the drug is unsafe for everyone or that everyone faces the same level of risk.

Get medical help right away if you think you are having a serious reaction.

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How To Save on Xarelto

Johnson & Johnson offers the Xarelto withMe Savings Card. Eligible people with commercial insurance may pay as little as $10 for up to a 90-day supply. If you have government insurance or no insurance, the website provides information on other ways to save.

Xarelto withMe also offers support, resources, and tools to help you navigate treatment.

To learn more, visit the Xarelto savings and support page or call 888-927-3586.

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What To Know Before Taking Xarelto

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Some medicines can increase the risk of bleeding when taken with Xarelto.

Before taking Xarelto, tell your doctor if you or your child:

• Have or have had bleeding problems
• Have liver or kidney problems
• Have antiphospholipid syndrome (APS), a condition that raises the risk of blood clots

Do not take Xarelto if you have active abnormal bleeding or are allergic to rivaroxaban or any of the ingredients in Xarelto.

Tell your doctors and dentists that you or your child take Xarelto before any surgery, medical procedure, or dental treatment. Your doctor may need to stop Xarelto temporarily to lower the risk of bleeding. Do not stop taking it without your doctor’s instructions because stopping too early can increase the risk of blood clots.

Xarelto is also FDA-approved to:

• Treat deep vein thrombosis (DVT) — DVT is a blood clot that forms in a deep vein, usually in the leg.
• Treat pulmonary embolism (PE) — PE is a blood clot that blocks a blood vessel in the lungs.
• Lower the risk of recurring blood clots — This helps prevent DVT or PE from happening again in adults who remain at risk after at least six months of treatment.
• Prevent blood clots after surgery — This lowers the risk of DVT after hip or knee replacement surgery in adults.
• Prevent blood clots during serious illness — This lowers the risk of blood clots and related death in certain hospitalized adults with limited movement who are not at high risk of bleeding. Treatment may continue after leaving the hospital.
• Treat and prevent recurring blood clots in children — This applies to children from birth to younger than 18 years, after at least five days of initial treatment with injectable blood thinners.

Instructions for missed doses depend on your prescribed dose and how often you take Xarelto. Talk with your doctor about what to do if you miss a dose.

Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Taking Xarelto during pregnancy may increase the risk of bleeding in you or your developing baby. Tell your doctor right away if you become pregnant during treatment.

Xarelto can pass into breast milk. Talk to your doctor about the best way to feed your baby while taking Xarelto.

Women who can become pregnant should also discuss pregnancy planning and the risk of severe uterine bleeding with their doctor.

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Community FAQs

These answers are fact-checked by our editorial staff.

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Learn More

On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.

Learn more about Xarelto and heart disease care:

• Xarelto — Johnson & Johnson
• Reducing Stroke Risk With Atrial Fibrillation (AFib) — MyHeartDiseaseTeam
• 3 Treatment Options for Atrial Fibrillation — MyHeartDiseaseTeam
• 6 Drugs To Avoid if You Have Atrial Fibrillation — MyHeartDiseaseTeam
• How Are Atrial Fibrillation Treatment Options Determined? — American Heart Association

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