Rivadem 1.5

Rivaroxaban is a medicine known as an anticoagulant or blood thinner. It helps prevent and treat blood clots. It is used to reduce the risk of stroke and heart attack. It prevents and treats clot formation in the veins of your legs, lungs, brain and heart. Rivaroxaban is commonly used in patients with irregular heart rhythm (atrial fibrillation) to prevent clot formation. It also reduces the risk of getting clots in people who have undergone knee or hip replacement surgeries. It should be taken with food and it is best to take them at the same time each day. You may need to take this medicine for many years, even for life in some cases. Do not stop taking it or change the dose without guidance from your doctor. It could quickly put you more at risk of having a heart attack, stroke or thrombosis (formation of a blood clot within a blood vessel). You can reduce your risk of having a blood clot by making changes to your lifestyle, such as not smoking, eating a healthy diet, getting regular exercise and losing weight if you need to. The most common side effect of Rivaroxaban is bleeding more easily than normal, for example, having nosebleeds or bruising. If you experience any symptoms, tell your doctor immediately. Other side effects include low blood pressure, skin rash, stomach ache, indigestion, and fever. Do not take this medicine if you have severe kidney or liver problems, if you are currently bleeding or if you are taking other medicines to reduce blood clotting. You should not breastfeed while using this medicine. Unlike other anticoagulants, a regular blood test (PT-INR) is not required while taking this medicine. Rivaroxaban is a novel oral anticoagulant (NOAC). It works by preventing the formation of blood clots in the body.

• Deep vein thrombosis • Pulmonary embolism • Stroke prevention

Factor Xa inhibitor that inhibits platelet activation by selectively blocking the active site of factor Xa without requiring a cofactor (eg, antithrombin III) for activity. Blood coagulation cascade is dependent on the activation of factor X to factor Xa via the intrinsic and extrinsic pathways plays a central role in the blood coagulation cascade. Dose-dependent inhibition of factor Xa activity observed; antifactor Xa activity is also influenced by rivaroxaban; prolongs PT and aPTT and HepTest .

Adult Dose: DVT Prophylaxis (Orthopedic Surgery) Indicated for prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) in patients undergoing knee or hip replacement surgery Knee replacement: 10 mg PO qDay for 12 days; may take with or without food Hip replacement: 10 mg PO qDay for 35 days; may take with or without food Administer initial dose at least 6-10 hr after surgery once hemostasis has been established Nonvalvular Atrial Fibrillation Indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation 20 mg/day PO with the evening meal DVT or PE Treatment Indicated for treatment of DVT and PE 15 mg PO q12hr for 21 days with food, THEN 20 mg PO qDay for 6 months Reduce risk for recurrent DVT or PE Indicated to reduce the risk of recurrence of DVT and PE following initial 6 months treatment for DVT and/or PE 20 mg PO qDay following initial 6 months of treatment for DVT and/or PE Hepatic impairment Moderate impairment: Not studied Avoid use in patients with moderate-to-severe impairment (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment or with any hepatic disease associated with coagulopathy Child Dose: Safety and efficacy not established Renal Dose: Renal impairment (nonvalvular AF) CrCl 30-50 mL/min: 20 mg/day CrCl 15-50 mL/min: 15 mg/day ESRD on intermittent renal dialysis: 15 mg/day Renal impairment (postoperative thromboprophylaxis) CrCl >50 mL/min: Dose adjustment not necessary CrCl 30-50 mL/min: Use with caution; dose adjustment not necessary CrCl <30 mL/min: Avoid use

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Rivaroxaban is to be taken with food.

If you miss a dose of Rivaroxaban, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Anemia (low number of red blood cells) • Nausea

[UNSAFE] Rivaroxaban may cause side effects which could affect your ability to drive. Rivaroxaban may cause dizziness or fainting. This may affect your driving ability. For best results, take Rivaroxaban at the same time every day. It is better to take at night with meals. It interacts less with food or other medicines. Hence, frequent dose changes are not required. It increases your risk of bleeding. Be careful while shaving, cutting fingernails or toenails, using sharp objects or engaging in contact sports (e.g. football, wrestling). It may cause dizziness. Avoid driving or activity requiring mental focus until you know how it affects you. If you are going to have a surgery or dental treatment, you may be asked to stop taking Rivaroxaban temporarily. Notify your doctor if you have any kidney problem. Inform your doctor if you are pregnant, planning pregnancy or breastfeeding. Do not stop taking medication without talking to your doctor.

Patient w/ active pathologic bleeding, significant risk of major bleeding (e.g. recent GI ulcer, oesophageal varices, recent brain, spine, or ophth surgery, recent intracranial haemorrhage, malignant neoplasms, vascular aneurysm).

Reduced hepatic & renal clearance w/ strong CYP3A4 inhibitors (clarithromycin, erythromycin, fluconazole). Increased bleeding risk w/ azole antimycotics (eg ketoconazole, itraconazole, voriconazole, posaconazole) or HIV-PIs (eg ritonavir); other anticoagulants; NSAIDs (including acetylsalicylic acid) & platelet aggregation inhibitors. Reduced plasma conc w/ CYP3A4 inducers (eg rifampicin, phenytoin, carbamazepine, phenobarb, St. John's wort). 20-mg FC tab: Increased prothrombin time/INR of warfarin.

[CAUTION] Caution is advised when consuming alcohol with Rivaroxaban. Please consult your doctor.

[CONSULT YOUR DOCTOR] Rivaroxaban may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[CONSULT YOUR DOCTOR] Rivaroxaban is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[CAUTION] Rivaroxaban should be used with caution in patients with kidney disease. Dose adjustment of Rivaroxaban may be needed. Please consult your doctor. Use of Rivaroxaban is not recommended in patients with severe kidney disease. [UNSAFE] Rivaroxaban is probably unsafe to use in patients with liver disease and should be avoided. Please consult your doctor.

Deep vein thrombosis , swelling nd painful in both leg. You need to take a surgical consultation Looking for a specialist in Deep vein thrombosis preferably in Kochi See a vascular surgeon In road accident head and small intestine got injured . 15 stiches on head and operation of 1 inch diameter of intestine . Now spo2 level is dropping to 70% after 1 hour of removing oxygen mask Get checked for pulmonary embolism or pneumothorax Wat is need of having xarelto after having ivc filter in body To prevent further clotting Taking xarelto 20 mg for last 15 months for DVT, also is hypertensive with sugar on borderline, Should i continue xarelto along with olmesar 40and metolar xr 50, how long , please suggest. Get Doppler done again and see fresh status GE my self v.k tiwari mbbs md i feel the patient information above is there any blood test for diagnosed pulmonary edema and pulmonary embolism Dear Sir There is no specific blood test for diagnosing pulmonary edema and embolism Thrombosis involving both main pulmonary arteries and branches . Sir the patent has been chest pain with thrombosis pulmonary in both arteries n branch So what is the solution n treatment for this patent Need to see you in person.can meet me at medanta.call 9XXXXXX I am suffering from pulmonary embolism. I want to know will i die because of this disease ? What is d extent of your disease