Dosing and Administration
IMPORTANT CORRECTION OF DRUG INFORMATION
Incorrect dosing information was inadvertently displayed on this website recently. This has been corrected as of March 19, 2014. Please see the full Prescribing Information and Medication Guide, which were not affected. See correct Dosing Information below. Click here for Healthcare Professional Letter.
XARELTO® provides convenient oral dosing, with no routine coagulation monitoring required.1-7 With XARELTO®, there is no need to adjust dosing based on age, body weight, or gender.
No routine coagulation monitoring required.1-7
Renal dosing considerations
Nonvalvular AF: Adjust XARELTO® dose based on renal function. Avoid using XARELTO® in patients with CrCl <15 mL/min. Periodically assess renal function as clinically indicated and adjust therapy. Discontinue XARELTO® in patients who develop acute renal failure.
All Other Indications: Avoid using XARELTO® in patients with CrCl <30 mL/min.
Please see full Prescribing Information for additional dosing considerations.
Switching patients to and from XARELTO®
*No clinical trial data are available to guide converting patients from XARELTO® to warfarin. XARELTO® affects INR, so INR measurements made during coadministration with warfarin may not be useful for determining the appropriate dose of warfarin.
†Oral or parenteral rapid-onset anticoagulants.
AF = atrial fibrillation; CrCl = creatinine clearance; DVT = deep vein thrombosis; PE = pulmonary embolism.
Temporary discontinuation for surgery and other procedures
If XARELTO® must be discontinued for a procedure, follow these guidelines:
Stop XARELTO® at least 24 hours before the procedure.
In deciding whether a procedure should be delayed until 24 hours after the last dose of XARELTO®, the increased risk of bleeding should be weighed against the urgency of intervention.
Restart XARELTO® as soon as adequate hemostasis is established.
If oral medication cannot be taken during or after the procedure, consider a parenteral anticoagulant.
Note that the half-life of XARELTO® is 5 to 9 hours in healthy subjects aged 20 to 45 years and 11 to 13 hours in the elderly.
Other administration options
For patients who are unable to swallow whole tablets:
Crush and mix a 15-mg or 20-mg XARELTO® tablet with applesauce immediately prior to use and administer orally.
Immediately follow the dose with food.
For administration via nasogastric (NG) tube or gastric feeding tube:
Confirm gastric placement of the tube, then crush a 15-mg or 20-mg XARELTO® tablet, suspend in 50 mL of water, and administer via an NG tube or gastric feeding tube.
Avoid administering XARELTO® distal to the stomach, which can result in reduced absorption and, thereby, reduced drug exposure.
Immediately follow the dose with enteral feeding.