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Xarelto (Rivaroxaban)
Brand name for: Rivaroxaban
Disclaimer: Images are for illustration purposes only. Brand-name products may appear different due to their country of origin—for example, medications from Canada will display "PR" on the packaging as required by law. For generic medications, we cannot guarantee a specific manufacturer, so appearances may vary, but rest assured the medication, dosage, and active ingredients will be exactly as prescribed. Your trust is important to us, and we're committed to providing you with safe and effective medications.
USA Price:
$1092.12
Our Price:
$104.95
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It is imperative to note that Duty Free Meds adheres strictly to regulations regarding the dispensing of medications. We do not ship any products without a valid and appropriately matched prescription from a licensed U.S. healthcare provider. Additionally, we reserve the right to refuse service if there are any indications that the prescription may have been fabricated or altered. Ensuring the integrity of the prescription process is essential for your safety and well-being.
Medically Reviewed By
Dr Abdul Razzaque Nohri
Pharm D, MBA, M.Phil & MSPH
Reviewed On:
July 22, 2026
Medication Overview
Xarelto (rivaroxaban) is a prescription anticoagulant that directly inhibits Factor Xa.
This medication is used to treat adults with Nonvalvular Atrial Fibrillation, Pulmonary Embolism, or Deep Vein Thrombosis. It is also used to help adults with Coronary Artery Disease, Peripheral Artery Disease, and procedures such as knee or hip replacements, as well as non-surgical hospitalizations. This medication may also be prescribed to some pediatric patients with DVT/PE (after at least five days of injectable anticoagulation) or Fontan.
Why Choose Xarelto (Rivaroxaban)?
There are many potential benefits that can be achieved from taking this medication.
- This medication is used to treat several different issues and has been used in both adult and pediatric patients
- Xarelto can also be combined with the use of aspirin in some cases to further reduce the risk of issues such as major thrombotic vascular events in adult patients struggling with PAD or CAD
- This medication is used to treat blood clots in the legs and lungs
- Xarelto reduces the risk of blood clots forming in the heart and traveling to the brain in adults with NVAF
- Xarelto can reduce the risk of future clotting events in people who remain at risk after initial treatment for DVT or PE
- This medication is also used to prevent clots in certain hospitalized patients and can lower the risk of serious cardiovascular events
Xarelto (Rivaroxaban) Drug Facts
| Brand Name: | Xarelto |
|---|---|
| Generic Name: | Rivaroxaban |
| Drug Class: | Factor Xa inhibitor |
| Indication: |
|
| Mechanism of Action: | Selectively inhibits Factor Xa, reducing thrombin generation and clot formation. |
| Dosage Forms: | Oral tablet or oral suspension |
| Strengths: |
|
| Half-life: | About 5-9 hours in healthy patients aged between 20 and 45 years old (or about 11-13 hours in older patients aged between 60 and 76 years old) |
| Manufacturer: | Bayer and Janssen Pharmaceuticals |
Xarelto Dosage Guide
Recommended Adult Dosages
Stroke Prevention in Nonvalvular Atrial Fibrillation Patients
The recommended dose depends on kidney function. Patients with a creatinine clearance (CrCl) greater than 50 mL/min should take 20 mg once daily and patients with a CrCl of 50 mL/min or less should take 15 mg once daily. Both doses should be taken with the evening meal.
Treatment of DVT and PE
Adults with a CrCl of 15 mL/min or higher typically start treatment with 15 mg twice daily for the first 21 days. The dose is generally changed to 20 mg once daily after this initial phase. Doses should be taken with food and at the same time each day. This medication is not recommended for patients with a CrCl below 15 mL/min.
Prevention of Recurrent DVT and PE
Adults who have completed at least six months of anticoagulant therapy and remain at risk for recurrent blood clots may take 10 mg once daily. This dose may be taken either with meals or on an empty stomach. Xarelto is generally not recommended for patients whose CrCl is below 15 mL/min.
Prevention of Blood Clots After Hip Replacement Surgery
It is generally recommended for patients to take 10 mg once daily for 35 days if they have a CrCl of 15 mL/min or greater. Treatment is typically started between six and 10 hours after surgery once adequate bleeding control has been achieved. The medication can be taken regardless of meals – either with food or on an empty stomach.
Prevention of Blood Clots After Knee Replacement Surgery
Adults are usually instructed to take 10 mg once daily for 12 days if they have a CrCl of 15 mL/min or greater. Treatment should begin six to 10 hours after surgery after hemostasis has been established. The dose can be taken regardless of meals
Prevention of Venous Thromboembolism in Acutely Ill Medical Patients
Adults hospitalized with an acute medical illness who are at risk for blood clots and do not have a high bleeding risk may receive 10 mg once daily. Treatment may continue during hospitalization and after discharge for a total duration of approximately 31 to 39 days. The medication can be taken regardless of meals
Reduction of Cardiovascular Risk in Coronary Artery Disease
Adults with CAD are typically prescribed 2.5 mg twice daily alongside 75 mg to 100 mg of aspirin once daily. No dose adjustment is generally required based on kidney function – although patients with severe renal impairment may have increased rivaroxaban exposure, and clinical experience in this population is limited.
Reduction of Thrombotic Risk in Peripheral Artery Disease (PAD)
For adults with peripheral artery disease – including those who have undergone lower-extremity revascularization – patients are typically prescribed 2.5 mg twice daily in combination with 75 mg to 100 mg of aspirin once daily. Treatment following a revascularization procedure should begin once bleeding has been adequately controlled. No dose adjustment is generally required based on kidney function (patients with severe renal impairment may have increased rivaroxaban exposure and clinical experience in this population is limited).
Recommended Pediatric Dosages
Treatment and Prevention of Recurrent VTE
Xarelto may be used in children from birth to under 18 years of age for the treatment of venous thromboembolism and to help prevent recurrent clotting events. Treatment should begin only after at least five days of initial anticoagulant therapy with an injectable blood thinner.
The recommended dose is determined by the child’s body weight. It may be given once daily, twice daily, or three times daily. Children weighing less than 30 kg generally receive the oral suspension and those weighing 30 kg or more may use either the oral suspension or tablets. The recommended dose is 20 mg once daily for children weighing 50 kg or more.
Infants Under 6 Months
Xarelto is not recommended for infants younger than six months unless all of the following conditions are met:
- Born at or beyond 37 weeks of gestation
- Have received at least 10 days of oral feeding
- Weigh at least 2.6 kg
Treatment should continue for at least three months in most pediatric patients. Therapy may be extended for up to 12 months if clinically appropriate. The decision to continue treatment should be based on the child’s risk of recurrent blood clots compared with the potential risk of bleeding. Children younger than two years old with catheter-related thrombosis should generally receive treatment for at least one month – with extension up to three months when medically necessary.
Prevention of Blood Clots After the Fontan Procedure
Xarelto may also be used to reduce the risk of blood clots in children aged two years and older with congenital heart disease who have undergone the Fontan procedure. Dosing is weight-based and may be administered once or twice daily. Children weighing 50 kg or more typically receive 10 mg once daily. Each dose should be taken with food or feeding to improve absorption for VTE treatment. Food does not affect dosing in patients receiving thromboprophylaxis post-Fontan procedure.
The dose may be repeated if vomiting or spitting up occurs within 30 minutes of a dose. The next dose should be taken at the regularly scheduled time if it occurs more than 30 minutes after administration. Children who cannot swallow whole tablets should use the oral suspension formulation or talk with their doctor.
Children with Kidney Impairment
No dose adjustment is generally required in children aged one year or older with mild kidney impairment. However, Xarelto is not recommended for pediatric patients with moderate or severe renal impairment due to limited clinical data. Kidney function should be evaluated before treatment in infants younger than one year. Use is not recommended when serum creatinine levels exceed age-specific reference ranges.
Missed Dose Instructions
Adults
Missed-dose recommendations depend on the prescribed regimen:
- 2.5 mg twice daily: Skip the dose that was missed and take the next scheduled 2.5 mg dose at the same time it is usually supposed to be taken.
- 15 mg twice daily: Patients should take the missed dose as soon as possible. They may take two of the 15 mg tablets together if needed to maintain the total daily dose of 30 mg.
- 10 mg, 15 mg, or 20 mg once daily: Take the dose that was missed as soon as it is remembered on the same day. Never double up on doses to make up for any skipped ones.
Children
Missed-dose instructions vary based on how often the medication is taken:
- Once daily: Patients should take the missed dose as soon as possible on the same day it was originally scheduled to be taken. Skip the dose and go back to following the regular schedule if this is not possible. Two doses of the medication should never be taken at the same time to make up for any that were missed.
- Twice daily: A forgotten morning dose can be taken later in the day and may be given with the evening dose if necessary. A missed evening dose may be taken only during the same evening.
- Three times daily: Skip the missed dose and continue with the next scheduled dose. A missed dose should not be replaced by taking an extra dose.
Using more Xarelto than prescribed may lead to a higher risk of major bleeding or hemorrhage. Patients who overdose should seek urgent medical or poison-control assessment.
Oral Suspension
Patients using the oral suspension version of this medication should only take their medication by mouth and give it exactly as prescribed. Pediatric patients should receive every dose from an adult caregiver. Use only the oral dosing syringe supplied with the medication. A pharmacist should be contacted for a replacement if the syringe is lost, damaged, or missing.
The “discard after” date should be checked prior to using the medication. The medication should not be used if this date has already passed. Patients should shake their dosing syringe before each dose gently for 10 seconds. Do not shake the medication vigorously (which may be evident by foaming). The medication may be reshaken gently if granules or lumps still appear at the bottom.
Measure the prescribed dose with the supplied oral syringe. Refill the syringe as needed until the full dose has been administered if the prescribed dose is greater than 5 mL.
Children taking this dose should have the medication slowly administered inside of their cheek and the entirety of the dose should be swallowed. A healthcare provider should be contacted if the child is repeatedly spitting out or vomiting the medication. The bottle cap should be placed back on the medication securely after each use. Tap water should also be used to rinse the oral syringe, before then allowing it to air dry. Never put this syringe in the dishwasher. The medication should be stored upright at room temperature in the original container. This medication should not be within reach of children or poured down the sink/drain if unused.
Precautions & Warnings
Black Box Warning
Xarelto has two different boxed warnings from the FDA. The first warning is against stopping the medication too soon. Doing so with this medication – or any oral anticoagulant – raises the risk of thrombotic event development. Doctors may recommend switching to another anticoagulant if the medication is being stopped for a reason other than the therapy being completed or pathological bleeding.
The second warning for this medication is for the potential development of epidural or spinal hematomas. This is mostly a concern for patients taking this medication at the same time as taking neuraxial anesthesia or undergoing a spinal puncture. Patients who do suffer from this effect may end up facing long-term or permanent paralysis. The risk of developing one of these hematomas is increased for those who have a history of spinal or epidural punctures that are either traumatic or repeated. Patients are also at increased risk if they are using indwelling epidural catheters or if they are using certain medications while using Xarelto. These medications include platelet inhibitors, NSAIDs, and other anticoagulants. Any patients using this medication should be routinely monitored for signs of any neurological impairment during their treatment.
Other Warnings and Contraindications
Xarelto increases patients’ risk of bleeding. Sometimes this bleeding can become serious or potentially fatal and a reverse agent may be necessary. Pregnant women should also be cautious when using this medication since it may lead to obstetric hemorrhage. It may also cause emergency deliveries for pregnant mothers in some cases.
This medication is not recommended for patients with prosthetic heart valves since some studies indicate that patients with a transcatheter aortic valve replacement may experience increased rates of bleeding and death. What this means for patients with other prosthetic heart valves or valve procedures is still unknown. This medication is also not recommended for patients with triple-positive antiphospholipid syndrome since the combination of the two has indicated increased rates of recurrent thrombotic events compared to the use of vitamin K antagonist therapy. Inform a healthcare provider of all medications and supplements being taken prior to starting this medication.
Stopping rivaroxaban before completing treatment may increase the risk of thrombotic events. Healthcare providers may consider transitioning the patient to another anticoagulant when appropriate if therapy is discontinued for reasons other than active pathological bleeding or the planned end of treatment. Those with severe hypersensitivities to this medication or any of its ingredients should refrain from taking the medication. Patients should also avoid using this medication if they have moderate or severe hepatic impairment or liver disease associated with coagulopathy.
Side Effects of Xarelto (Rivaroxaban)
Bleeding was the most frequently recorded side effect for adults taking this medication. The most common side effects experienced by children taking this medication were:
- Cough
- Vomiting
- Bleeding
- Inflamed gut or stomach
Doctors should be notified about the best way to deal with these side effects. Serious or persistent side effects should be reported immediately and emergency medical attention should be sought.
Serious Side Effects
Xarelto may cause serious side effects that require immediate medical attention such as:
- Blood clots after stopping treatment (discontinuing Xarelto without medical guidance may increase the risk of blood clots, stroke, or other serious complications)
- Severe bleeding due to the reduction in the blood’s ability to clot (the risk may be higher when taken with certain medications like aspirin, NSAIDs, or other blood thinners)
- Spinal or epidural hematomas (blood clots may develop around the spinal cord after spinal procedures or epidural anesthesia on rare occasions and potentially lead to permanent paralysis)
Patients should seek immediate medical attention if they experience signs of serious bleeding – including prolonged or uncontrolled bleeding – unusual or unexplained bruising, or coughing up blood. The same goes for if the patient experiences:
- Any unusual bleeding that is severe or difficult to stop (this includes frequent nosebleeds, bleeding gums, or heavy menstrual bleeding)
- Abnormal urine or stool color
- Coughing up blood or blood clots
- Vomit that contains blood or resembles coffee grounds
- Severe headache, dizziness, or weakness
- Persistent pain, swelling, or drainage from a wound
Patients should contact their healthcare provider immediately if they develop back pain or numbness/tingling. They should also contact their healthcare provider immediately if they experience muscle weakness – particularly in the legs – or loss of bladder or bowel control. Xarelto is not recommended for patients with artificial heart valves or certain forms of antiphospholipid syndrome.
Drug Interactions:
This medication has some known drug interactions listed on its label. This includes known interactions with:
- Strong Combined CYP3A4 and P-Glycoprotein (P-gp) Inhibitors
These medications can increase rivaroxaban concentrations and raise the risk of serious bleeding. Examples include ketoconazole and ritonavir. - Strong Combined CYP3A4 and P-Glycoprotein (P-gp) Inducers
These medications can reduce rivaroxaban concentrations and decrease its anticoagulant effect, potentially increasing the risk of thrombotic events. Examples include carbamazepine and phenytoin. They also include rifampin and St. John’s wort. - Medications that Increase Bleeding Risk
Concomitant use of anticoagulants, antiplatelet agents (including aspirin), nonsteroidal anti-inflammatory drugs (NSAIDs), and other medications that affect hemostasis may increase the risk of bleeding.
Patients should talk to their doctor before combining any of these medications with the use of Xarelto. They should also make sure their healthcare provider is aware of any medications or supplements that they are currently taking before starting their treatment.
Xarelto Storage and Handling
Store Xarelto at room temperature between 68°F and 77°F (20°C to 25°C). Brief exposure to temperatures ranging from 59°F to 86°F (15°C to 30°C) is acceptable. Discard any remaining medication after the expiration or discard date marked on the bottle/packaging. Never store this medication in freezing conditions or let it become frozen. This medication will be shipped to patients’ homes in the U.S. in appropriate packing to maintain these safe storage conditions and the quality of the medication.
Alternatives: to Xarelto
| Medication | Type | Approved Uses | Manufacturer | Half-life | Dosing Frequency | Available Strengths | Administration | Renal Considerations | Reversal Agents |
|---|---|---|---|---|---|---|---|---|---|
| Xarelto | Factor Xa inhibitor |
| Bayer and Janssen Pharmaceuticals | About 5 to 9 hours in healthy adult patients | Once or twice daily (depending on the specific use) |
| Oral tablet or suspension |
|
|
| Eliquis | Factor Xa inhibitor |
| Bristol Myers Squibb | Approximately 8–15 hours (average ~12 hours) | Twice daily |
| Oral tablet |
|
|
| Pradaxa | Direct thrombin inhibitor |
| Boehringer Ingelheim | About 12 to 17 hours in healthy adult patients | Once or twice daily (depending on the specific use) |
| Oral capsule or oral pellets |
|
|
Frequently Asked Questions (FAQ)
Do I need an Xarelto (Rivaroxaban) prescription to place an order?
Yes. Xarelto requires a valid prescription from a licensed healthcare provider and it cannot be dispensed without one. Patients should only use this medication under medical supervision due to its effects on blood clotting.
Can I order Xarelto in the US from Canada?
Yes, Xarelto can be shipped from Canada to the U.S. when ordering from Duty Free Meds with a valid prescription.
Is there a generic version of Xarelto?
Yes. Generic rivaroxaban is available and contains the same active ingredient as Xarelto. However, availability may vary depending on the pharmacy, country, and strength prescribed.
How much does Xarelto cost monthly?
The monthly cost of Xarelto can vary based on factors such as dosage, insurance coverage, and the specific pharmacy from which the product is dispensed. The cost of this medication without insurance can sometimes be over $800 per month. However, those with insurance may be able to pay as little as $10 per month. This same medication can be ordered from places like Duty Free Meds in Canada at prices starting at around $105 per month for those without insurance.
In what ways are Xarelto and Eliquis different?
Xarelto (rivaroxaban) and Eliquis (apixaban) are both Factor Xa inhibitors used to prevent and treat blood clots. However, they contain different active ingredients. These medications also have different dosing schedules, approved uses, and prescribing considerations. A healthcare provider can help determine which option is best suited for the specific patient.
Is Xarelto cheaper than Eliquis?
The cost difference between Xarelto and Eliquis depends on factors such as the prescribed dose, pricing at the specific pharmacy it is being purchased from, and insurance coverage. Eliquis is generally cheaper and usually costs a little under $400 per month without insurance per month in the U.S. or it may be found from places like Duty Free Meds in Canada at prices starting around $77 per month. Xarelto can often be over $800 per month for those without insurance in the U.S. or may be found in Canada at prices starting at around $105 per month.
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Our Guarantee For Buying Xarelto From A Canadian Pharmacy Partner
Duty Free Meds is dedicated to providing reliable, top-quality medications with safety as our highest priority. We strictly adhere to the regulatory standards of each country we operate in, partnering exclusively with licensed Canadian pharmacies or vetted international providers to fulfill your order. Every product we offer is fully authorized by Health Canada or other respected organizations, including the MHRA in the United Kingdom, HSA in Singapore, and the Pharmacy Board of Mauritius. The medications are identical in composition to those available in the U.S., differing only in packaging that reflects their country of origin. We sell only genuine, authorized medications, and every order is thoroughly reviewed by our licensed healthcare team to ensure it matches your prescription precisely. To secure Xarelto at a reduced price, simply place your order above or call us at +1 888-234-2007.
Disclaimer: The information presented here is intended solely for educational purposes and should not be interpreted as medical advice, a diagnosis, or specific treatment recommendations. It does not imply endorsement of any particular medication or therapy. Health conditions and treatment responses can differ significantly between individuals; thus, this information is not a guarantee of safety, suitability, or effectiveness for anyone in particular. Always seek the guidance of a healthcare professional for personalized medical advice and consult them before making any health or treatment decisions.
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