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RIVOXAN 10: Usual dose: Prevention of venous thromboembolism (VTE) in patients undergoing orthopedic surgery of the lower limbs: Knee replacement: Oral: 10 mg once daily; 6 to 10 hours postoperatively, recommended total duration of therapy: 14 days.
Hip replacement: Oral: 10 mg once daily; 6 to 10 hours postoperatively, recommended total duration of therapy: 35 days.
Special population: Geriatric: Refer to adult dosing (usual dose).
Renal Impairment: Mild to moderate renal impairment: No dosage adjustment necessary.
Severe renal impairment: Avoid use.
Hepatic Impairment: Mild impairment (Child-Pugh class A): There are no dosage adjustment provided.
Limited data indicates pharmacokinetics and pharmacodynamics response were similar to healthy subjects.
Moderate to severe impairment (Child-Pugh class B or C) and any hepatic disease associated with coagulopathy: Avoid use.
Mode of administration: Dose ≤ 10 mg/day may be administered without regard to meals.
For nasogastric/gastric feeding tube administration, the tablets may be crushed and mixed in 50 mL of water, administer the suspension with 4 hours of preparation. Ten mg tablet may be administered without regards to food.
Patients receiving once-daily dosing who miss a dose should take a dose as soon as possible on the same day; resume therapy the following day as previously taken.
RIVOXAN 15 and RIVOXAN 20: Usual dose: Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: Oral: 20 mg once daily with the evening meal.
The recommended maximum daily dose of 20 mg.
Treatment of DVT and PE: Oral: Initial: 15 mg twice daily with food for 21 days followed by 20 mg once daily with food.
The recommended maximum daily dose of 30 mg during the first 3 weeks of treatment.
In the following treatment phase the recommended maximum daily dose is 20 mg.
Prevention of recurrent of DVT and PE: Oral: 20 mg once daily with food.
Special population: Geriatric: Refer to adult dosing (usual dose).
Renal Impairment: For Nonvalvular atrial fibrillation: CrCl > 50 mL/minute: No dosage adjustment necessary.
CrCl 15 to 50 mL/minute: 15 mg once daily with the evening meal; discontinue use in patients who develop acute renal failure. Some recommend to avoid use in patients with CrCl < 30 mL/minute.
CrCl < 15 mL/minute: discontinue use in patients who develop acute renal failure. Some recommend to avoid use in patients with CrCl < 30 mL/minute.
For Treatment of DVT and PE and prevention of recurrent DVT and PE: CrCl ≥ 30 mL/minute: No dosage adjustment necessary.
CrCl < 30 mL/minute: Avoid use.
Hepatic Impairment: Mild impairment (Child-Pugh class A): There are no dosage adjustment provided.
Limited data indicates pharmacokinetics and pharmacodynamics response were similar to healthy subjects.
Moderate to severe impairment (Child-Pugh class B or C) and any hepatic disease associated with coagulopathy: Avoid use.
Mode of administration: Administer doses ≥ 15 mg/day with food.
For nasogastric/gastric feeding tube administration, the tablets may be crushed and mixed in 50 mL of water, administer the suspension with 4 hours of preparation and follow administration of 15 mg and 20 mg tablets immediately with enteral feeding.
Patients receiving 15 mg twice daily dosing who miss a dose should take a dose immediately to ensure 30 mg of rivaroxaban is administered per day (two 15 mg tablets may be taken together); resume therapy the following day as previously taken.
Patients receiving once-daily dosing who miss a dose should take a dose as soon as possible on the same day; resume therapy the following day as previously taken.
Conversion: Conversion from warfarin: Discontinue warfarin and initial rivaroxaban as soon as INR falls to < 3.0.
Conversion to warfarin: Discontinue rivaroxaban and initiate both warfarin and a parenteral anticoagulant at the time the next dose of rivaroxaban would have been taken or continue rivaroxaban concomitantly with warfarin until INR ≥ 2 and then discontinue rivaroxaban.
Conversion from continuous infusion unfractionated heparin: Initiate rivaroxaban at the time of the heparin discontinuation.
Conversion to continuous infusion unfractionated heparin: Discontinue rivaroxaban and initiate continuous infusion unfractionated heparin at the time the next dose of rivaroxaban would have been taken.
Conversion from anticoagulants (other than warfarin and continuous infusion unfractionated heparin): Discontinue current anticoagulant and initiate rivaroxaban ≤ 2 hours prior to the next regularly scheduled evening dose of the discontinued anticoagulant.
Conversion to other anticoagulants (other than warfarin): Discontinue rivaroxaban and initiate the anticoagulant at the time the next dose of rivaroxaban would have been taken.
