Rivaroxaban
- Class: Direct factor Xa inhibitor
- Used for: blood clots
- Say it: riv-uh-ROX-uh-ban
- Forms: tablet, oral liquid
RIVAROXABAN = a BAN on factor Xa, with the X sitting in plain sight in the middle of the name.
Like apixaban, the target is spelled out. Blocking a single factor directly is why no INR is needed — the effect follows predictably from the dose.
Rivaroxaban, apixaban and edoxaban all end in -xaban and all block factor Xa directly. Warfarin works further upstream on vitamin K, which is why it needs monitoring and they do not.
Side effects
Common: bruising, nosebleeds, anemia
Serious: major bleeding, spinal hematoma
Typical dose
20 mg once daily with food
15 mg if creatinine clearance is 15–50. Food is not optional — absorption falls sharply without it.
Check yourself
Why does rivaroxaban not require INR monitoring, when warfarin does?
- It blocks a single factor directly, so its effect is predictable from the dose
- It is a weaker anticoagulant
- It is cleared entirely by the kidney
- It does not affect the clotting cascade at all
Show answer
A. It blocks a single factor directly, so its effect is predictable from the dose
Warfarin blocks the vitamin-K-dependent production of several factors, and that output swings with diet, genetics and other drugs — hence the INR. Rivaroxaban binds factor Xa itself, so the same dose produces much the same effect in most patients.
See it, don't memorize it
The app has the mechanism comic and a patient case for Rivaroxaban – plus the name link, the class mnemonic, pronunciation you can hear, and a self-check, for the top 100 drugs. One purchase, no subscription, no account.