Varox Tablet | 1 Strip

✔️ Side Effects

Most common: bleeding risk (including fatal bleeding), spinal/epidural hematoma, and increased risk of stroke upon discontinuation in nonvalvular atrial fibrillation.

✔️ Dosage & Administration

For ACS: 2.5 mg twice daily with 75–100 mg Aspirin daily, with or without 75 mg Clopidogrel or standard-dose Ticlopidine.

Nonvalvular Atrial Fibrillation:

CrCl > 50 mL/min: 20 mg once daily with evening meal.

CrCl 15–50 mL/min: 15 mg once daily with evening meal.

DVT & PE Treatment: 15 mg twice daily with food for 21 days, then 20 mg once daily with food.

Prevention of DVT/PE Recurrence: 20 mg once daily with food.

Post-hip replacement prophylaxis: 10 mg once daily for 35 days.

Post-knee replacement prophylaxis: 10 mg once daily for 12 days.
May be taken with or without food (except where food intake is specified).

✔️ Drug Interactions

Avoid with combined P-gp and CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin, erythromycin, fluconazole, diltiazem, verapamil, dronedarone) due to increased exposure and bleeding risk.

Avoid with P-gp and strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine) due to reduced efficacy.

Caution with antiplatelet agents, heparin, fibrinolytics, and NSAIDs, as these increase bleeding risk.

✔️ Contraindications

Hypersensitivity to Rivaroxaban or excipients.

Active pathological bleeding.

✔️ Pregnancy & Lactation

Category C: No adequate human studies; dosing not established for pregnancy.

Unknown if excreted in breast milk; safety not established in breastfeeding.

✔️ Precautions & Warnings

• Stopping therapy early without alternative anticoagulation increases thrombotic risk.
• Bleeding risk is higher in patients with bleeding disorders, uncontrolled hypertension, GI diseases (IBD, oesophagitis, gastritis, GERD), vascular retinopathy, bronchiectasis, or a history of pulmonary bleeding.
• Monitor for neurological symptoms if neuraxial anesthesia or spinal puncture is performed (risk of spinal/epidural hematoma).
• Not recommended in PE with hemodynamic instability or when thrombolysis/pulmonary embolectomy is planned.

✔️ Storage:

Store below 30 °C, in a cool, dry place away from light and out of reach of children.