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)



(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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