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It is important to continue taking rivaroxaban as prescribed by your doctor. Stopping this medication without medical advice can increase your risk of developing serious blood clots, such as strokes or clots in the legs and lungs. Your doctor might suggest an alternative anticoagulant or antiplatelet medication to help mitigate this risk. If you experience symptoms like weakness on one side of your body, difficulty speaking, sudden vision changes, confusion, chest pain, breathing difficulties, or pain, warmth, and swelling in your legs, seek immediate medical assistance.

• Rivaroxaban users may experience bleeding near the spinal cord following certain spinal procedures, which could lead to long-term or even permanent paralysis. Consult your doctor about the potential benefits and risks before undergoing any spinal procedure.
• The risk of bleeding increases if you have spinal deformities, have undergone previous spinal surgeries or procedures (such as epidural catheter placement or a difficult epidural/spinal puncture), or are using medications that can increase bleeding or bruising. These include antiplatelet drugs like clopidogrel, anticoagulants like warfarin or enoxaparin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
• Contact your doctor immediately if you notice symptoms such as back pain, numbness, tingling, or weakness in the legs, or a loss of bowel or bladder control (incontinence).

Minor side effects like easy bruising or slight bleeding, such as nosebleeds or bleeding from small cuts, might occur. Usually, these are not a cause for concern, but if they persist or worsen, it's advisable to consult your healthcare provider. This medication is generally well-tolerated by many users.

However, it's important to be aware of more serious side effects. This medication might affect blood clotting proteins, leading to significant bleeding issues. Seek medical attention immediately if you experience frequent or unstoppable nosebleeds, unusual fatigue, pain, swelling, discomfort, or bruising. Other signs of serious bleeding include prolonged bleeding from cuts or gums, heavy menstrual flow, pink or dark urine, coughing up blood, vomiting blood or material resembling coffee grounds, severe headaches, dizziness, fainting, bloody or black stools, and difficulty swallowing.

In rare cases, this medication can trigger a severe allergic reaction, which requires urgent medical help. Watch for symptoms such as rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing. This summary does not cover all possible side effects, so if you notice any other unusual symptoms, contact your healthcare provider for guidance.

Certain medications may interact with this drug. These include mifepristone and other drugs that can increase bleeding or bruising risk, like antiplatelet medications (such as clopidogrel), NSAIDs (like ibuprofen or naproxen), and anticoagulants (such as warfarin or enoxaparin). Some antidepressants, including SSRIs (e.g., fluoxetine) and SNRIs (such as desvenlafaxine or venlafaxine), can also interact.

Additionally, some drugs can alter how rivaroxaban is processed in your body, impacting its effectiveness. Examples include cobicistat, dronedarone, ritonavir, certain azole antifungals (like itraconazole, ketoconazole, posaconazole), HIV protease inhibitors (such as lopinavir), rifamycins (like rifampin), St. John's wort, and medications for seizures (such as carbamazepine, phenytoin, phenobarbital).

Aspirin may increase bleeding risk when used with this medication. However, if your doctor has advised you to take low-dose aspirin (usually 81-162 milligrams daily) for heart attack or stroke prevention, continue using it unless your doctor advises otherwise. For further details, consult your doctor or pharmacist.