This drug has boxed warnings, the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
Risk of blood clots if Xarelto is stopped too soon. Stopping Xarelto treatment too soon raises your risk of developing blood clots. It’s important that you do not stop taking Xarelto unless your doctor tells you to do so. If needed, you and your doctor can discuss and consider other medications to prevent blood clots.
Risk of blood clots in or around the spine. Xarelto increases your risk for blood clots in or around the spine if you undergo certain spinal procedures. The procedures include spinal injections, epidural injections, and lumbar puncture (spinal tap). These blood clots are called epidural or spinal hematomas and can cause long lasting or permanent paralysis.
Xarelto is a brand-name prescription medication that contains the active drug rivaroxaban. It belongs to a class of drugs called direct oral anticoagulants. These are a type of blood thinner. Xarelto is not available in a generic form.
This medication has been approved by the Food and Drug Administration (FDA) for the following uses in adults:
- preventing blood clots and stroke in those who have atrial fibrillation (AFib) not caused by a heart valve problem
- treating deep vein thrombosis (DVT) or pulmonary embolism (PE)
- reducing the risk of another DVT or PE in those who have had a blood clot treated before
- preventing DVT or PE following hip replacement or knee replacement surgery
- preventing blood clots in hospitalized patients who are at risk
- preventing blood clots that may cause heart attack, stroke, or death in those who have coronary artery disease (CAD), to be taken in combination with aspirin
- preventing certain complications caused by blood clots in those who have peripheral artery disease (PAD), to be taken in combination with aspirin
In addition, the FDA has approved this medication for the following uses in children:
- treating and preventing blood clots in veins in children of any age
- preventing blood clots following a Fontan heart procedure in children ages 2 years and older who were born with heart disease
In this article, you’ll find additional information about Xarelto’s dosage and details on how to take the drug. For a comprehensive overview of Xarelto, refer to this article.
Finding a healthcare professional
If you’re interested in taking Xarelto, search here to find a doctor who might prescribe it.
This article describes typical recommended dosages for Xarelto. These dosages are provided by the drug’s manufacturer.
Always follow the dosage of Xarelto that your doctor prescribes.
Commonly recommended dosages for Xarelto are shown below.
You should take the dosage your doctor prescribes for you.They’ll recommend the dosage that’s best for your condition.
Xarelto’s forms and strengths
Xarelto is available as follows.
| Dosage form | Strengths |
| oral tablets | • 2.5 milligrams (mg) • 10 mg • 15 mg • 20 mg |
| oral liquid suspension | • 1 mg per milliliter (mL) (1 mg/mL) once mixed |
Adult dosage
The recommended dosages of Xarelto for approved uses in adults are described below.
Typical recommended dosage for preventing blood clots and stroke in atrial fibrillation (AFib)
Below is an overview of Xarelto’s recommended dosage for preventing blood clots in adults who have AFib. Your doctor will prescribe the dosage of Xarelto that’s right for your condition.
- Dose for AFib: 20 mg (this is both the starting dose and maximum daily dosing)
- Frequency: once per day in the evening
Typical recommended dosage for treating deep vein thrombosis (DVT) or pulmonary embolism (PE)
Below is an overview of Xarelto’s recommended dosage for treating DVT or PE in adults. Your doctor will prescribe the Xarelto dose for DVT or the dose for PE that’s right for you.
- Starting dosage: 15 mg twice per day for the first 21 days
- Maintenance dosage: 20 mg once per day
Typical recommended dosages for other uses
The table below summarizes Xarelto’s recommended dosages for the drug’s other uses in adults.
| Purpose | Recommended dose | Frequency |
| reducing risk of another DVT/PE in those who have had a blood clot before | 10 mg | once per day |
| preventing DVT or PE following hip replacement or knee replacement surgery | 10 mg | • following hip replacement surgery: once per day for 35 days • following knee replacement surgery: once per day for 12 days |
| preventing blood clots in hospitalized patients at risk of them | 10 mg | once per day, for up to 31 to 39 days |
| preventing blood clots that may cause heart attack, stroke, or death in those who have coronary artery disease (CAD) | 2.5 mg | twice per day |
| preventing certain complications caused by blood clots in those who have peripheral artery disease (PAD) | 2.5 mg | twice per day |
Children’s dosage
The recommended dosages of Xarelto for its approved uses in children are described below. These dosages depend on the child’s body weight in kilograms (kg). (One kg equals about 2.2 pounds [lb].)
Typical recommended dosage for treating and preventing blood clots in veins in children
The table below summarizes the recommended dosages of Xarelto for treating and preventing blood clots in veins in children of any age.
| Body weight in kg | Approximate body weight in lb | Dose and form | Frequency |
| 2.6 kg to 2.9 kg | 5.7 lb to 6.4 lb | 0.8-mg suspension | three times per day |
| 3 kg to 3.9 kg | 6.6 lb to 8.6 lb | 0.9-mg suspension | three times per day |
| 4 kg to 4.9 kg | 8.8 lb to 10.8 lb | 1.4-mg suspension | three times per day |
| 5 kg to 6.9 kg | 11 lb to 15.2 lb | 1.6-mg suspension | three times per day |
| 7 kg to 7.9 kg | 15.4 lb to 17.4 lb | 1.8-mg suspension | three times per day |
| 8 kg to 8.9 kg | 17.6 lb to 19.6 lb | 2.4-mg suspension | three times per day |
| 9 kg to 9.9 kg | 19.8 lb to 21.8 lb | 2.8-mg suspension | three times per day |
| 10 kg to 11.9 kg | 22 lb to 26.2 lb | 3-mg suspension | three times per day |
| 12 kg to 29.9 kg | 26.4 lb to 65.8 lb | 5-mg suspension | twice per day |
| 30 kg to 49.9 kg | 66 lb to 109.8 lb | 15-mg suspension or tablet | once per day |
| 50 kg or more | 110 lb or more | 20-mg suspension or tablet | once per day |
For example, assume a child weighing 15 kg (about 33 lb) is prescribed Xarelto oral liquid suspension for this use. The child’s dose will be 5 mg, taken twice per day.
The Xarelto oral liquid suspension contains 1 mg of the drug in each milliliter (mL). In this example, the child will take 5 mL twice per day.
Typical recommended dosage for preventing blood clots in certain children
The table below summarizes the recommended dosages of Xarelto for preventing blood clots in certain children. Specifically, Xarelto is used following a Fontan procedure (a type of heart surgery) in children ages 2 years and older who were born with heart disease.
| Body weight in kg | Approximate body weight in lb | Dose and form | Frequency |
| 7 kg to 7.9 kg | 15.4 lb to 17.4 lb | 1.1-mg suspension | twice per day |
| 8 kg to 9.9 kg | 17.6 lb to 21.8 lb | 1.6-mg suspension | twice per day |
| 10 kg to 11.9 kg | 22 lb to 26.2 lb | 1.7-mg suspension | twice per day |
| 12 kg to 19.9 kg | 26.4 lb to 43.8 lb | 2-mg suspension | twice per day |
| 20 kg to 29.9 kg | 44 lb to 65.9 lb | 2.5-mg suspension | twice per day |
| 30 kg to 49.9 kg | 66 lb to 109.8 lb | 7.5-mg suspension | once per day |
| 50 kg or more | 110 lb or more | 10-mg suspension or tablet | once per day |
For example, assume a child weighing 55 kg (about 121 lb) is prescribed Xarelto oral tablet for this use. The child’s dose will be 10 mg, taken once per day.
Length of treatment
Doctors typically prescribe Xarelto as a long-term treatment, but not in every case. For example, when used for preventing DVT or PE following hip replacement surgery, Xarelto treatment will last 35 days.
When used for preventing DVT or PE following knee replacement surgery, Xarelto treatment will last 12 days.
Your doctor will tell you more about your length of treatment with Xarelto for your condition.
Below are some common questions related to Xarelto’s dosage.
Is there a Xarelto dose for DVT prophylaxis?
Xarelto may be prescribed for deep vein thrombosis (DVT) prophylaxis (prevention) in certain situations.
The dose for this use is detailed above. Refer to the table under “Typical recommended dosages for other uses” in the “Xarelto: Dosage” section. To learn more about Xarelto’s dosage, you can also ask your doctor or pharmacist.
Will my dose of Xarelto be adjusted if I have renal (kidney) problems?
It’s likely that your doctor will adjust your Xarelto dose if you have moderate or severe kidney problems. An example is moderate or severe chronic kidney disease.
Your body relies on your kidneys to get rid of Xarelto after you take a dose. Having kidney problems could cause Xarelto levels in your body to rise. This could increase your risk of side effects.
Does Xarelto have a dosing guide?
Xarelto has recommended dosages for its approved conditions. These help doctors determine appropriate amounts of Xarelto to prescribe.
To learn more about Xarelto’s dosages, read the “Xarelto: Dosage” section above. You can also talk with your doctor or pharmacist.
Is there specific Xarelto dosing for older people?
No, Xarelto doesn’t have specific dosing for older people. However, some doctors may prescribe older adults a lower Xarelto dose.
Older adults are more likely to have kidney or liver problems. These problems can affect how the body responds to Xarelto. Older adults are also more likely to take multiple medications, which raises the risk for drug interactions with Xarelto.
If you’re an older adult, discuss Xarelto dosage with your doctor. They can provide information on determining the safest dose for you that works for your condition.
What is the Xarelto starter pack dosing schedule?
Doctors may prescribe a Xarelto starter pack for treating deep vein thrombosis (DVT) or pulmonary embolism (PE) in adults.* It contains the first 30-day supply of Xarelto.
For these conditions, Xarelto dosage typically starts with 15 mg, taken twice per day for 21 days. Then treatment continues with 20 mg, taken once per day.
To learn more about Xarelto’s dose, review the “Xarelto: Dosage” section above. You can also talk with your doctor or pharmacist.
* The Xarelto starter pack dosing isn’t used for people who have severe kidney disease.
Your doctor will consider several factors when prescribing the dosage for Xarelto. These factors include:
- your age
- your body weight, for children prescribed Xarelto
- the condition you’re taking Xarelto to treat
- the severity of your condition
- the form of Xarelto you’re taking
Your prescribed dosage may also vary based on other medical conditions you have.
Recommended adjustments in dosage
Your doctor may adjust your Xarelto dose if you have moderate or severe kidney problems. An example is chronic kidney disease (CKD).
Ask your doctor for more information about dosage adjustments.
Xarelto comes in two forms. It comes as an oral tablet and an oral liquid suspension. You’ll take either form by mouth.
In adults, the timing of food depends on the dose you take. Xarelto doses of 15 mg or 20 mg should be taken with food. Xarelto doses of 10 mg or less may be taken with or without food.
In children, the timing of food depends on the reason Xarelto was prescribed. For treating blood clots in veins in children, Xarelto should be taken with food. For preventing blood clots following a Fontan heart procedure, the drug may be taken with or without food.
Xarelto tablets are usually swallowed whole. You should not cut the tablets. However, adults who have trouble swallowing Xarelto may crush the tablet and mix it into applesauce or water. Your doctor or pharmacist can tell you more about this.
Xarelto liquid suspension is available for children who are unable to swallow Xarelto tablets. If your child takes Xarelto liquid suspension, be sure to measure their dose using the oral syringe that comes with the drug. A household spoon is not accurate for measuring medication.
If you take Xarelto once per day, your doctor will likely recommend that you take it around the same time each day. If you take Xarelto twice per day, you’ll take your doses about 12 hours apart. And if your child takes Xarelto three times per day, they’ll take their doses about 8 hours apart. Following a regular schedule will help maintain a consistent amount of the drug in your body. This can help Xarelto work effectively.
If you find it challenging to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies provide medication labels with large print or braille. They may also offer labels containing a scannable code that your smartphone can convert from text to speech. If your pharmacy doesn’t provide these choices, your doctor or pharmacist may be able to recommend a pharmacy that does.
If it’s difficult for you to open medication bottles, ask your pharmacist if they can dispense Xarelto in an easy-open container. They also may recommend ways to help make it easier to open the bottles.
If you miss a dose of Xarelto, your next steps depend on your dosage or dose frequency. See the tables below for details. You can also talk with your doctor or pharmacist for advice.
Missed dose of Xarelto in adults
The table below summarizes what to do if an adult misses a dose of Xarelto.
| Dosage | What to do if a dose is missed |
| 2.5 milligrams (mg) twice per day | • skip the missed dose • take your regular dose at the next scheduled time |
| 10 mg, 15 mg, or 20 mg once per day | • take the missed dose as soon as possible if within the same day • if this is not possible, skip the missed dose and take your regular dose at the next scheduled time |
| 15 mg twice per day | • take the missed dose as soon as possible • you may take two doses at the same time to ensure you receive 30 mg total per day |
Missed dose of Xarelto in children
The table below summarizes what to do if a child misses a dose of Xarelto.
| Dose frequency | What to do if a child’s dose is missed |
| once per day | • take the missed dose as soon as possible if within the same day • if this is not possible, skip the missed dose and take your regular dose at the next scheduled time |
| twice per day | • take the missed dose as soon as possible • you may take two doses at the same time |
| three times per day | • skip the missed dose • take your regular dose at the next scheduled time |
Try one of these medication reminder options to help avoid missing doses. You could also set an alarm or download a reminder app on your phone.
Vomited or spit-up dose of Xarelto oral liquid suspension in children
Some children may vomit or spit up after taking Xarelto oral liquid suspension. In that case, your next steps depend on the time of their last dose.
- If it occurs within 30 minutes after taking a dose: They should repeat the dose.
- If it occurs more than 30 minutes after taking a dose: Do not give another dose. They’ll take their regular dose at the next scheduled time.
Ask your child’s doctor for advice if your child frequently vomits or spits up after taking Xarelto.
If you take more than the recommended dosage of Xarelto, serious bleeding can occur. Do not take more Xarelto than your doctor prescribes.
What to do in case of overdose
Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.
Talk with your doctor or pharmacist for additional information about Xarelto’s dosage. Keep in mind that the dosages presented in this article are typical dosages provided by the drug’s manufacturer. Your doctor will recommend the dosage of Xarelto that’s right for you and your condition. Always follow the dosage that your doctor prescribes for you.
As with any medications you’re taking, do not change your Xarelto dosage without a recommendation from your doctor.
In addition to discussing Xarelto with your doctor, you may find the following articles helpful in learning more.
- Overview of Xarelto. For comprehensive details on Xarelto, refer to this article.
- Drug comparisons. To learn how Xarelto compares with Eliquis, read this article.
- Information on side effects. If you’d like to know about possible side effects of Xarelto, refer to this article.
- Details about Xarelto’s uses. To learn more about the conditions Xarelto is used to treat, refer to these articles on pulmonary embolism and deep vein thrombosis.
Disclaimer: Healthgrades 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.
