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It is important to follow your healthcare provider's instructions when taking rivaroxaban. Discontinuing the medication without your doctor's guidance may increase the likelihood of developing serious blood clots, such as a stroke or clots in the legs or lungs. Your physician might suggest an alternative anticoagulant or antiplatelet medication to manage these risks.

Please be aware of the following safety information and precautions:

• Seek immediate medical attention if you experience symptoms such as sudden weakness on one side of your body, difficulty speaking, abrupt changes in vision, confusion, chest pain, trouble breathing, or pain, warmth, or swelling in the legs.
• There is a risk of bleeding near the spinal cord during certain spinal procedures, which could result in long-term or permanent paralysis. Discuss the potential risks and benefits with your doctor prior to any spinal procedure.
• The likelihood of bleeding may increase if you have a spinal deformity, have undergone previous spinal surgeries or procedures (such as epidural catheter placement or complicated epidural/spinal puncture), or are using other medications that may cause bleeding or bruising, including antiplatelet drugs (e.g., clopidogrel), anticoagulants (e.g., warfarin, enoxaparin), or nonsteroidal anti-inflammatory drugs (e.g., ibuprofen).
• Contact your healthcare provider immediately if you experience symptoms like back pain, numbness, tingling, or weakness in the legs, or loss of bladder or bowel control.

Always consult with your doctor for personalized advice and never hesitate to reach out to them with any concerns or questions about your medication.

When taking this medication, you might experience mild side effects like easy bruising or minor bleeding, such as nosebleeds or bleeding from cuts. These are generally not concerning unless they persist or worsen. However, be vigilant for serious side effects, which can include significant bleeding. Warning signs of serious bleeding include frequent or unstoppable nosebleeds, unusual tiredness, pain, swelling, or discomfort, unexpected bruising, prolonged bleeding from cuts or gums, heavier or longer menstrual periods, 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 extremely rare cases, this medication may cause very serious bleeding. These symptoms include changes in vision, confusion, trouble speaking, and weakness on one side of the body, which require immediate medical attention. Additionally, a serious allergic reaction is rare but possible. Watch for rash, itching or swelling, especially of the face, tongue, or throat, severe dizziness, or trouble breathing, and seek medical help right away if these occur.

While this list covers many potential side effects, it is not exhaustive. If you experience any other unusual symptoms, contact a healthcare professional for guidance.

This medication may interact with several other drugs. It is important to be aware of these interactions to ensure safe use. Drugs that can increase the risk of bleeding or bruising when taken with this medication include mifepristone, antiplatelet drugs like clopidogrel, NSAIDs such as ibuprofen and naproxen, and blood thinners like warfarin and enoxaparin. Additionally, certain antidepressants, specifically SSRIs like fluoxetine and SNRIs such as desvenlafaxine and venlafaxine, may also interact.

Certain medications can influence how this drug is processed in the body, potentially altering its effectiveness. These include cobicistat, dronedarone, ritonavir, certain azole antifungals such as itraconazole, ketoconazole, and posaconazole, HIV protease inhibitors like lopinavir, rifamycins such as rifampin, St. John's wort, and seizure medications like carbamazepine, phenytoin, and phenobarbital.

Aspirin can also increase bleeding risk when used with this medication. However, if your healthcare provider has advised you to take low-dose aspirin (typically 81-162 milligrams daily) to prevent heart attacks or strokes, continue to do so unless instructed otherwise. Always consult your doctor or pharmacist for more information.