What should be observed when weaning Xarelto®?


Xarelto® is a trade name for the active ingredient rivaroxaban. This is an anticoagulation drug, colloquially a blood thinner. The family doctor treating you will closely monitor your intake and should not stop taking it without his instructions.

However, discontinuation of Xarelto® is necessary under certain circumstances. This should also only be done on the doctor’s instructions. If Xarelto® is discontinued, serious complications may occur.

What should be observed when weaning Xarelto®?

Xarelto® is an active ingredient that is prescribed for good reason by the treating family doctor. Weaning should never be done without consulting the doctor. After discontinuing Xarelto®, the risk of blood clots forming increases significantly and sufferers can develop strokes, heart attacks, vascular occlusion and many other life-threatening complications.

In the event of intolerance to Xarelto®, a new active ingredient should therefore be used immediately and not just Xarelto® discontinued. The time without treatment with anticoagulants should be kept as short as possible. If the medication is changed, the risk of bleeding also increases, which is a major problem with Xarelto® , since there is no direct antidote for Xarelto® .

If there are signs of bleeding, a doctor should therefore be consulted immediately. The effect of Xarelto® diminishes significantly after just a few hours or days after discontinuation and must therefore be monitored closely. However, it is not necessary to check the level of Xarelto® in the blood, either during the intake or when discontinuing it.

There are several reasons why Xarelto® must be discontinued permanently or temporarily. For some procedures with a high risk of bleeding, anticoagulants must be discontinued beforehand, if this is responsible. Small operations, such as dental surgery, are often performed despite the use of Xarelto®.

For larger operations, Xarelto® must be discontinued one or two days before. The exact time should be clarified with your anaesthetist in the preliminary consultation. After the operation, Xarelto® should be taken again as soon as possible after consultation with the doctor.

If discontinuation is too risky, the necessity of the operation must be clarified. If renal dysfunction is above a certain level, Xarelto® must also be discontinued, as half of Xarelto® is excreted via the kidneys. In the event of acute or chronic bleeding, for example in the gastrointestinal tract, a doctor should be consulted to discuss whether Xarelto® should be discontinued.

Xarelto® should also not be used during pregnancy and while breastfeeding. In case of serious side effects or allergic reactions to ingredients of Xarelto®, an alternative to anticoagulation should be discussed with Xarelto® and Xarelto® should be discontinued. The half-life of Xarelto® is between five and thirteen hours.

This means that half of the active ingredient is no longer detectable. However, the exact end of the effect depends on the biological half-life. Many individual factors, such as kidney function and the age of the person affected, play a role here. It is therefore not possible to give an exact time. Before operations, a safety interval of about 24 hours is planned, as the effect is normally weakened far enough by then.