Dosing and Administration for DVT and PE Treatment and Risk Reduction
A single-agent treatment approach
XARELTO® offers the convenience of a single, oral agent with no routine coagulation monitoring1-3 for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and for extended risk reduction.
XARELTO® Starter Pack for DVT and/or PE treatment
This convenient pack provides treatment for the first 30 days for a seamless transition of care from diagnosis to follow-up. Learn more
XARELTO® (10 mg, 15 mg or 20 mg) can be administered orally (as a whole or crushed tablet) or via nasogastric (NG) tube (as a crushed-tablet suspension) followed by food or enteral feeding (not required for 10-mg dose)
See how to switch patients to and from XARELTO®
View bleed management information for XARELTO®
Renal dosing considerations
DVT and PE and reduction in risk of recurrence: Avoid using XARELTO® in patients with CrCl <30 mL/min
Please see full Prescribing Information for additional dosing considerations.
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, noting that the time to onset of therapeutic effect is short
If oral medication cannot be taken during or after surgical procedures, 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 10-mg, 15-mg or 20-mg XARELTO® tablet with applesauce immediately prior to use and administer orally
Immediately follow the 15-mg or 20-mg dose with food (not required for 10-mg dose)
For administration via NG tube or gastric feeding tube:
Confirm gastric placement of the tube, then crush a 10-mg, 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 15-mg or 20-mg dose with enteral feeding (not required for 10-mg dose)
CrCl = creatinine clearance; NG = nasogastric.