Xarelto (rivaroxaban) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to treat or prevent blood clots in adults and children, in certain situations.
Xarelto comes as an oral tablet and an oral liquid suspension. It contains the active drug rivaroxaban. This drug belongs to a group of drugs called anticoagulants, which are also known as blood thinners. Xarelto works by inhibiting (blocking the action of) a blood clotting factor in the body called Factor Xa. It’s currently only available as a brand-name medication.
For information on the dosage of Xarelto, including its forms, strengths, and how to take the drug, keep reading. For a comprehensive look at Xarelto, including its full uses, see this article.
This article describes typical dosages for Xarelto provided by the drug’s manufacturer. When taking Xarelto, always follow the dosage prescribed by your doctor.
Xarelto is approved to treat or prevent blood clots in certain people. Below is information on typical dosages.
Xarelto comes as an oral tablet and an oral liquid suspension.
The suspension is a liquid mixture that’s prepared by a pharmacist. It’s typically prescribed for children.
Xarelto strengths (2.5 mg, 10 mg, 15 mg, 20 mg, 1 mg/mL)
Xarelto tablets come in in four strengths: 2.5 milligrams (mg), 10 mg, 15 mg, and 20 mg. Xarelto suspension comes in a strength of 1 mg per milliliter (mL).
The normal dosage for Xarelto depends on the condition you’re taking the drug for. The following information describes dosages that are commonly used or recommended for each indication Xarelto is used for. (Indication refers to the condition you’re taking Xarelto to treat or prevent.) However, be sure to take the dosage your doctor prescribes for you.
Your doctor will monitor you during Xarelto treatment to make sure your dose is therapeutic. A therapeutic dose is the amount of drug that’s needed to be effective but low enough not to be harmful to your body. A therapeutic dose of Xarelto provides enough of the drug to treat or prevent blood clots, but not enough to make your blood too thin.
Dosage for reducing risk of stroke and blood clots in adults with AFib
Xarelto is used to reduce the risk of stroke and blood clots in adults who have atrial fibrillation (AFib) that’s not caused by a heart valve problem. The typical dosage of Xarelto for this use is 20 mg once per day in the evening, with food.
Dosage for preventing DVT and PE after hip or knee replacement
Xarelto is used in adults to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip replacement or knee replacement surgery. DVT is a clot that forms in a vein deep in the body (usually your leg or pelvis). And PE is a clot that breaks free from a vein and travels toward your lungs.
The typical dosage of Xarelto after hip replacement is 10 mg per day for 35 days. And, the typical dosage after knee replacement is 10 mg per day for 12 days. For these uses, you can take Xarelto with or without food.
Your doctor will typically start your Xarelto treatment while you’re in the hospital after your procedure.
Dosage for reducing the risk of reoccurring DVT or PE in adults
If you’ve had DVT or PE and you’ve taken blood thinners for at least 6 months to treat it, your doctor may have you start taking Xarelto. The typical dosage for this use is 10 mg once per day, either with or without food.
Dosage for treating DVT and PE in adults
If you have DVT or PE, your doctor will typically have you start taking 15 mg of Xarelto twice per day. After 3 weeks (21 days), your doctor will switch you to 20 mg of Xarelto once per day. For this use, you should take your dose with food, at the same time every day.
Dosage for preventing VTE in people who are ill
Xarelto is used to prevent venous thromboembolism (VTE) in adults who are currently or recently hospitalized due to illness. VTE is a blood clot that forms in a vein.
The typical dosage of Xarelto for this use is 10 mg, once per day. You’ll likely start taking Xarelto while you’re in the hospital. When you go home from the hospital, your doctor may have you continue taking 10 mg of Xarelto for up to 39 days in total. (This includes the number of days you took Xarelto while in the hospital.)
For this use, you can take Xarelto with or without food.
Dosage for reducing the risk of cardiovascular events in adults with CAD or PAD
Xarelto is used to reduce the risk of cardiovascular events in adults with coronary artery disease (CAD) or peripheral artery disease (PAD). Cardiovascular events include heart attack and stroke.
For this use, the typical dosage of Xarelto is 2.5 mg, twice per day with or without food. And it’s often taken with 75 mg to 100 mg of aspirin once per day. These drugs used together help reduce your risk for blood clots and serious cardiovascular events.
Dosage before surgery
Your doctor will usually have you stop taking Xarelto for a short time before having any surgery. This includes dental procedures.
Before having any surgical or dental procedure, make sure your doctor knows that you’re taking Xarelto. If you need emergency surgery, you may receive an antidote to Xarelto before surgery. (An antidote is a medication that reverses the effect of a drug.)
Dosage for people with kidney problems
If you have kidney problems, your doctor may start you on a lower Xarelto dosage than usual.
Your kidneys process Xarelto. So if your kidney function is low, you may not be able to take Xarelto for certain conditions. Talk with your doctor about any kidney problems you have before starting Xarelto.
In children, Xarelto’s recommended dosage is based on body weight in kilograms (kg).* Your child’s weight will be monitored while they’re taking Xarelto in case dosage adjustments are needed. The recommended Xarelto dosages in children are described below.
* One kg equals about 2.2 pounds (lb).
Dosage for VTE treatment and prevention in children
Xarelto can be prescribed for venous thromboembolism (VTE) treatment and prevention in children of all ages. Refer to the table below for the drug’s recommended dosages.
|Child’s body weight||Typical Xarelto dosage||Total daily Xarelto dose|
|2.6 kg to 2.9 kg (about 5.7 lb to 6.4 lb)||0.8 mg suspension three times per day||2.4 mg|
|3 kg to 3.9 kg (about 6.5 lb to 8.6 lb)||0.9 mg suspension three times per day||2.7 mg|
|4 kg to 4.9 kg (about 8.8 lb to 10.8 lb)||1.4 mg suspension three times per day||4.2 mg|
|5 kg to 6.9 kg (about 11 lb to 15.2 lb)||1.6 mg suspension three times per day||4.8 mg|
|7 kg to 7.9 kg (about 15.4 lb to 17.4 lb)||1.8 mg suspension three times per day||5.4 mg|
|8 kg to 8.9 kg (about 17.6 lb to 19.6 lb)||2.4 mg suspension three times per day||7.2 mg|
|9 kg to 9.9 kg (about 19.8 lb to 21.8 lb)||2.8 mg suspension three times per day||8.4 mg|
|10 kg to 11.9 kg (about 22 lb to 26 lb)||3 mg suspension three times per day||9 mg|
|12 kg to 29.9 kg (about 26.4 lb to 65.9 lb)||5 mg suspension twice per day||10 mg|
|30 kg to 49.9 kg (about 66 lb to 110 lb)||15 mg once per day, as a tablet or suspension*||15 mg|
|50 kg or more (about 110.2 lb or more)||20 mg once per day, as a tablet or suspension*||20 mg|
For VTE treatment in children, doctors usually prescribe Xarelto for at least 3 months. They may recommend having your child take Xarelto for up to 12 months.
Children should take Xarelto with food when they’re being treated for VTE.
* Children who weigh 30 kg or more may be prescribed Xarelto tablets or suspension for VTE treatment. Children who weigh less than 30 kg are given the suspension, which is easier to swallow.
Dosage for blood clot prevention in children with congenital heart disease
The table below describes Xarelto’s recommended dosages for blood clot prevention in children ages 2 years and older who have had the Fontan procedure for congenital heart disease.
|Child’s body weight||Typical Xarelto dosage||Total daily Xarelto dose|
|7 kg to 7.9 kg (about 15.4 lb to 17.4 lb)||1.1 mg liquid suspension twice per day||2.2 mg|
|8 kg to 9.9 kg (about 17.6 lb to 21.8 lb)||1.6 mg liquid suspension twice per day||3.2 mg|
|10 kg to 11.9 kg (about 22 lb to 26.2 lb)||1.7 mg liquid suspension twice per day||3.4 mg|
|12 kg to 19.9 kg (about 26.4 lb to 43.8 lb)||2 mg liquid suspension twice per day||4 mg|
|20 kg to 29.9 kg (about 44 lb to 65.9 lb)||2.5 mg liquid suspension twice per day||5 mg|
|30 kg to 49.9 kg (about 66 lb to 110 lb)||7.5 mg liquid suspension once per day||7.5 mg|
|50 kg or more (about 110.2 lb or more)||10 mg once per day, as a tablet or liquid suspension*||10 mg|
Children can take their Xarelto doses with or without food for this use.
* Children who weigh 50 kg or more may be prescribed Xarelto tablets or suspension. Children who weigh less than 50 kg are given the suspension, which is easier to swallow.
Xarelto is meant to be used as a long-term treatment for some conditions. When used to treat VTE in children, Xarelto is typically prescribed for at least 1 to 3 months. It can be used for up to 12 months for this purpose.
Your doctor will tell you how long you or your child should take Xarelto.
The Xarelto dosage your doctor prescribes will depend on the type and severity of the condition you’re using Xarelto to treat or prevent. Other medical conditions you have can also affect your Xarelto dosage.
Doctors may prescribe a lower Xarelto dosage than usual in adults who have liver or kidney problems. This is because these conditions may affect how your body responds to Xarelto. Specifically, you may have more side effects from the drug, or the drug may be less effective.
Before starting Xarelto, tell your doctor about any medical conditions you have. You’ll likely have blood or urine tests to check your liver and kidney function before and during Xarelto treatment. Based on these tests, your doctor may increase or decrease your starting dosage if needed.
If your child is taking Xarelto, their weight will be monitored during treatment in case their dosage needs to be adjusted.
If you have questions about adjustments to your Xarelto dosage, talk with your doctor or pharmacist.
Below are answers to some frequently asked questions about Xarelto.
What’s the Xarelto dosage for older adults?
Xarelto’s dosage is based on the condition you’re taking the drug for. The drug’s dosage in adults does not change based on age.
See the “Xarelto dosage” section above for recommended dosages for each condition Xarelto is used to treat. If you have questions about taking Xarelto based on your age, talk with your doctor or pharmacist.
Do Xarelto side effects vary with dosage?
There is an increased risk of bleeding with higher dosages of Xarelto. Otherwise, no side effects have been reported to vary significantly based on dosage.
Mild bleeding, such as from a minor cut, may take longer than usual to stop. You may also bleed or bruise more easily than usual. Severe bleeding can be life threatening. See this article for more information about this side effect.
If you’re concerned about the side effects and risks of taking Xarelto, talk with your doctor. They can discuss the risks and benefits of using Xarelto with you and help you decide if it’s the best choice for your condition.
Xarelto comes as a tablet and a liquid suspension. Both forms are swallowed.*
The suspension comes with oral syringes that you’ll use to measure each dose of Xarelto. Avoid using a spoon to measure doses of Xarelto suspension, as this isn’t accurate.
How often you take Xarelto depends on the condition you’re being treated for. You should try to take your dose(s) at about the same time(s) each day.
You can take Xarelto with or without food most of the time, but some conditions require that you take Xarelto with food and at a specific time of day. Children taking Xarelto for venous thromboembolism (VTE) should take their doses with food. Children taking Xarelto after the Fontan procedure can take Xarelto with or without food.
Always follow your doctor’s instructions for exactly how to take Xarelto. See the “Xarelto dosage” section above for details.
Note: Xarelto has a
* If needed, Xarelto liquid suspension may be given through a feeding tube, such as a nasogastric (NG) tube.
What you should do if you miss a dose of Xarelto depends on your Xarelto dosage.
If you’re taking 10 mg, 15 mg, or 20 mg of Xarelto once a day: Take your missed dose as soon as you remember. But if it’s almost time for your next daily dose, skip your missed dose and take your next scheduled dose as usual. Do not “double up” on doses. Children taking Xarelto once per day should also follow these guidelines.
If you’re taking 2.5 mg of Xarelto twice a day: Skip your missed dose and take your next scheduled dose as usual. Do not “double up” on doses.
If you‘re taking 15 mg of Xarelto twice a day: Take your missed dose as soon as you remember. If it’s time to take your next dose, you can take the two doses together. But, do not take more than two doses in one day unless your doctor tells you to do so. Children taking Xarelto twice per day should also follow these guidelines.
For children taking Xarelto three times per day: Your child should skip a missed dose and take their next dose as usual.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
It’s important that you do not take more Xarelto than your doctor advises. Taking more Xarelto than your doctor prescribes can cause hemorrhage (severe bleeding) to occur.
Symptoms of an overdose
Symptoms of severe bleeding from taking too much Xarelto can include:
- bleeding that’s unexpected or long lasting, such as nose bleeds
- unusual bleeding from your gums
- menstrual bleeding that’s heavier than usual
- blood in your urine, which may look pink or brown
- black or tarry stools
- coughing up blood
- vomiting blood, which may look red or like coffee grounds
- dizziness or weakness
- new or worsening pain, swelling, or oozing of wounds
If you take more than the recommended amount of Xarelto
Call your doctor right away if you believe you’ve taken too much of Xarelto. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Xarelto for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Xarelto without your doctor’s approval. If you have questions about the dosage of Xarelto that’s right for you, talk with your doctor.
Besides learning about dosage, you may want other information about Xarelto. These additional articles might be helpful to you:
- More about Xarelto. For information about other aspects of Xarelto, refer to this article.
- Side effects. To learn about the side effects of Xarelto, see this article. You can also look at Xarelto’s prescribing information.
- Drug comparison. To learn how Xarelto compares with Eliquis, see this article.
- Interactions. For details about Xarelto’s interactions, see this article.
- Cost. For information about the cost of Xarelto treatment, refer to this article.
- A look at cardiovascular health. To learn about the conditions Xarelto is prescribed for, our cardiovascular health hub may be helpful.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.