Dosing and Administration for DVT Prophylaxis After Knee or Hip Replacement Surgery
Convenient, oral dosing with no routine coagulation monitoring
XARELTO® offers convenient, oral, once-daily dosing and administration with no routine coagulation monitoring.1-4 XARELTO® provides a consistent approach to protecting against deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) after knee or hip replacement surgery, after discharge and during recovery.
XARELTO® (10-mg) can be administered orally (as a whole or crushed tablet) or via nasogastric (NG) tube (as a crushed-tablet suspension)
See how to switch patients to and from XARELTO®
View bleed management information for XARELTO®
Renal dosing considerations
DVT prophylaxis after knee or hip replacement surgery: 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 XARELTO® tablet with applesauce immediately prior to use and administer orally
For administration via NG tube or gastric feeding tube:
Confirm gastric placement of the tube, then crush a 10-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
CrCl = creatinine clearance.