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Switching Patients to and From XARELTO®

Conversion guidelines

For patients who require anticoagulation, the summary below offers direction for converting patients between XARELTO® and warfarin, unfractionated heparin, or other anticoagulants.

From warfarin
Stop warfarin and start XARELTO® when INR is <3.0
From unfractioned heparin
Stop the infusion and start XARELTO® at the same time
From other anticoagulants
Start XARELTO® 0 to 2 hours prior to the next scheduled evening administration of the other anticoagulant (eg, LMWH) and omit administration of the other anticoagulant
To warfarin*
One approach is to stop XARELTO® and start parenteral anticoagulant and warfarin at time of next scheduled XARELTO® dose
To other anticoagulants
Stop XARELTO® and start other anticoagulant when the next dose of XARELTO® would have been given

*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.

INR = international normalized ratio.

Download Switching Chart, including Dosing Summary


Explore additional features of XARELTO®, including bleed management information and the mechanism of action.






Indication and Important saftey Information


  • Reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). There are limited data on the relative effectiveness of XARELTO® (rivaroxaban) and warfarin in reducing the risk of stroke and systemic embolism when warfarin therapy is well controlled.
  • Treatment of deep vein thrombosis (DVT).
  • Treatment of pulmonary embolism (PE).
  • Reduction in the risk of recurrence of DVT and/or PE in patients at continued risk for recurrent DVT and/or PE after completion of initial treatment lasting at least 6 months.
  • Prophylaxis of DVT, which may lead to PE in patients undergoing knee replacement surgery.
  • Prophylaxis of DVT, which may lead to PE in patients undergoing hip replacement surgery.