Introduction
Xarelto® is a drug containing the active ingredient rivaroxaban. This is a NOAK, a new drug for oral anticoagulation, colloquially known as blood thinning. Anticoagulation is a serious, but in many cases necessary, intervention in body function, blood clotting and therefore has some side effects and possible complications. These range from intolerance to severe bleeding. In case of serious side effects, the treating physician should always be consulted and the dose should not be changed independently.
Side effects of Xarelto
The side effects of Xarelto® can be classified according to frequency. Common side effects are: Occasional side effects are: Rare side effects are: Very rare side effects are:
- Anemia
- Dizziness and headaches
- Eye and conjunctival hemorrhages
- Nosebleeds
- Bleeding gums
- Bleeding in the gastrointestinal tract
- Nausea and vomiting
- Constipation or diarrhea
- Itching
- Pain in the extremities
- Blood in urine
- Fever
- Water retention
- Tiredness and bleeding after surgery
- Blood count changes
- Allergic reactions
- Cerebral hemorrhages
- Liver dysfunction
- Jaundice
- Muscle Bleeding
- Liver inflammation
- Allergic shock
- The Stevens-Johnson syndrome
- DRESS syndrome
Bleeding in the gastrointestinal tract can have various causes. Often minor injuries or bulges are the cause.
Ulcers and tumors can also bleed. Taking Xarelto® does not increase the likelihood of bleeding, but prevents the bleeding from stopping and therefore leads to greater blood loss, which is more likely to be noticed. Such bleeding is manifested either by black stool, so-called tar stool, or, in the case of deeper causes, by fresh blood in the stool.
In the case of vomiting, the vomit may look like coffee grounds. In either case, the actual cause of the bleeding must be found. Especially in the cold season the mucous membranes of the nose are often irritated and dry.
With slight irritation, such as during nose blowing, the veins can burst and bleed. Bleeding may be heavier in people who take Xarelto® because Xarelto® has a blood-thinning effect. This can lead to major blood loss.
Local compression, i.e. squeezing the nose, can often stop the bleeding. If bleeding does not stop, a doctor should be consulted or, in the case of very heavy bleeding and associated circulatory problems, the emergency medical services should also be informed. Haematomas, colloquially known as bruises, are ruptured blood vessels under the skin.
In blunt injuries, blood can accumulate under the skin and is broken down within a few days. When Xarelto® is taken, hemostasis takes longer, which is why even small bumps can lead to particularly large bruises. Even after the blood has been drawn, patients often develop large hematomas.
These are not dangerous and the blood is broken down normally. Due to the slower hemostasis, affected persons have the feeling of developing haematomas much more frequently, but these are only more clearly visible. Operations are always associated with a risk of bleeding and also with a risk of post-operative bleeding.
This risk increases when taking Xarelto®, as natural hemostasis is limited. During an operation, the body is injured in a targeted manner, and although sutures are applied, they do not heal completely until later. In the case of major operations with a high risk of bleeding, it may be necessary to discontinue Xarelto® temporarily.
A doctor should always be consulted in the event of post-operative bleeding. There is no direct antidote to the effect of Xarelto® , so bleeding must be treated symptomatically. Since there is a high risk of bleeding all over the body when taking Xarelto®, patients often lose small amounts of blood at different sites.
Small bleedings in the gastrointestinal tract, bruises and nosebleeds therefore lead to blood loss that the body cannot always compensate for directly. Those affected therefore develop anemia, i.e. a lack of blood. In severe cases, this anemia must be compensated with blood products.
Blood formation can also be increased by medication. Fatigue is a typical symptom of anemia, which is a relatively common side effect of taking Xarelto®. The red blood cells transport oxygen around the body and the brain in particular requires a lot of oxygen.Frequent bleeding thus leads to the loss of red blood cells and thus to a poorer oxygen supply.
The brain saves oxygen by reducing its performance and the affected person feels tired and weak. Headaches are another frequent side effect of taking Xarelto®. This is due on the one hand to the poorer oxygen supply to the brain and thus to concentration problems, and on the other hand to visual problems caused by bleeding.
In the event of severe headaches after banging the head, patients should go directly to hospital, as the probability of a cerebral hemorrhage is increased when taking Xarelto®. Relatives should also be aware of this risk and should dial the emergency number if anything unusual happens after a fall on the head. Dizziness can occur in the brain as well as in the inner ear.
If Xarelto® is taken, the brain may be undersupplied with oxygen, which can also lead to dizziness. If the dizziness becomes more severe with further symptoms, a cerebral hemorrhage is also a possible cause, as this can occur more frequently when taking Xarelto® than in people who do not take this drug. In the case of dizziness attacks, the person affected should not go to the doctor alone, as the risk of falling is increased.
Particularly people with an already increased tendency to fall can benefit from transport by a patient transport company. Taking Xarelto® increases the likelihood of bleeding in all parts of the body. In the case of minor injuries, which do not normally lead to heavy bleeding, sufferers develop bruising.
This also occurs in joints and muscles and therefore often leads to movement pain after sports activities or minor injuries. In the case of larger blunt injuries, there is a risk of compartment syndrome. This is a constriction of nerves and muscle tissue due to increased bleeding and represents an acute danger.
In case of significant movement restrictions, the treating physician should be consulted. Due to the frequent small bleedings throughout the body, a blood deficiency, i.e. anemia, can develop when taking Xarelto®, as the new blood cannot keep up with the loss. This leads to an oxygen deficiency throughout the body.
The body prioritizes which cells are vital and therefore the first to be supplied with oxygen. Since hair is not essential for life, even a slight deficiency causes the hair follicles to be poorly supplied and the hair falls out. Blood formation can be promoted by certain dietary supplements and medications and hair loss can be stopped.
It is important, however, that large sources of bleeding are identified and the cause is fought. Taking Xarelto® leads to an increase in transaminases (liver enzymes) in about one tenth of those affected. However, as long as there are no further symptoms, this has no disease value.
In some cases, however, other liver values may also increase and in rare cases those affected develop inflammation of the liver, also known as hepatitis. This is not an infectious and contagious form of hepatitis, but an inflammation triggered by the medication and previous damage to the liver alone. Those affected are conspicuous by jaundice.
In the studies on Xarelto®, no direct connection could be found between Xarelto intake and erectile dysfunction. However, erectile dysfunction has many causes and is particularly dependent on the blood flow and the elasticity of the blood vessels. Since men who take Xarelto® often have underlying diseases of the cardiovascular system, the cause of erectile dysfunction is more likely to be found in these pre-existing conditions.
