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This safety information for rivaroxaban is vital to ensure its safe use. It is crucial to follow your healthcare provider's instructions and be aware of the potential risks associated with this medication. Please review the following points carefully:

• Do Not Discontinue Abruptly: Stopping rivaroxaban suddenly can significantly increase the risk of serious blood clots, including stroke or heart attack. Always consult with your healthcare provider before discontinuing, as they may prescribe an alternative anticoagulant to mitigate this risk.

• Spinal Bleeding Risk: There is a heightened risk of bleeding around the spinal cord, which may lead to long-term or permanent paralysis, especially during spinal procedures such as taps or epidurals. Discuss the benefits and risks with your healthcare provider before any spinal procedure. Notify your provider immediately if you experience symptoms like back pain, numbness, tingling, weakness, or loss of bladder or bowel control.

• Increased Bleeding Risk: Rivaroxaban can lead to serious, potentially life-threatening bleeding. In emergencies, reversal agents such as Andexxa (andexanet alfa) may be used, although they can be more complex than those for other blood thinners. Ensure all healthcare providers are aware you are taking rivaroxaban; wearing a medical bracelet indicating this can be helpful.

• Drug Interactions: Some medications can alter the levels of rivaroxaban in your body, affecting its efficacy or increasing side effects. Inform your healthcare provider about all the medications you are taking, including prescriptions, over-the-counter drugs, vitamins, and herbal supplements. Notable interactions include ketoconazole and ritonavir, which may increase bleeding risk, and carbamazepine and rifampin, which may decrease effectiveness.

• Contraindications: Do not use rivaroxaban if you have active bleeding conditions. Discuss with your healthcare provider if this applies to you.

If you experience any worrying symptoms or in the event of an overdose, seek medical attention immediately. Your cooperation and diligence in managing your health are essential while using this medication.

Common side effects:

• minor bleeding
• cough
• vomiting
• symptoms of a stomach virus
• rash

• itchy skin

  Less common but important to monitor:

• stomach pain
• unusual tiredness
• pain in the arms and legs
• muscle pain and spasms
• dizziness
• anxiety

• trouble sleeping

  Serious side effects:

• severe bleeding
• coughing up blood
• bloody stools
• vomit resembling coffee grounds
• severe allergic reactions
• vision changes
• difficulty speaking
• weakness on one side of the body

When taking Xarelto (rivaroxaban), it's crucial to be aware of potential drug interactions. This medication may interact with several other drugs and supplements. Always inform your healthcare provider about all the medications and supplements you are currently using, including prescription, over-the-counter, vitamins, and herbal products.

Certain medications are not recommended to be used with Xarelto. For instance, defibrotide should generally be avoided. There are also many other medicines that may not be recommended but might be necessary in some cases. These include anticoagulants like Warfarin, apixaban, and Dabigatran; antiplatelet drugs such as Clopidogrel and Aspirin; NSAIDs like Ibuprofen and Naproxen; certain antidepressants including SSRIs such as Fluoxetine, and SNRIs like Venlafaxine; as well as antifungals like Itraconazole and Ketoconazole. If these medications are necessary, your doctor might adjust your dosage or how often you take them.

Additionally, some medications can interfere with the elimination of rivaroxaban from your body, potentially affecting its effectiveness. These include HIV protease inhibitors like Ritonavir, Rifampin, and St. John's Wort, as well as drugs for seizures like Carbamazepine and Phenobarbital.

Moreover, using Xarelto with medications like Amiodarone, Cyclosporine, diltiazem, and Erythromycin may increase the risk of side effects, but sometimes these combinations are needed for treatment. In such cases, your doctor will closely monitor your treatment and may adjust doses as necessary.

Remember, if your doctor has advised taking low-dose aspirin for heart health, continue doing so unless directed otherwise. Always consult your healthcare provider for the most suitable advice regarding your medications.