Rivaroxaban is a new oral anticoagulant that can be used as prophylactic therapy to prevent thromboembolism following hip or knee arthroplasty.
Mechanism of action: inhibition of activated Factor X (Xa)
Contraindications:
(1) creatinine clearance < 15 mL/min
(2) concurrent therapy with ketoconazole, itraconazole, ritonavir, other protease inhibitors (increased levels due to inhibition of cytochrome P450 3A and P-glycoprotein)
(3) concurrent therapy with rifampicin (reduced levels due to induction of P450 3A4 and P-glycoprotein)
Usual oral daily dose: 10 mg once per day
First dose: 6 to 8 hours after surgery
Duration of therapy: 10-14 days following knee arthroplasty, 28-35 days following hip arthroplasy
Monitoring: not usually performed
Effects on screening tests: prolongation PT and aPTT
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