If you’re at risk for having certain types of blood clots, your doctor might suggest Xarelto (rivaroxaban) as a treatment option.
Xarelto is a prescription medication that’s used for the following purposes in adults:
- to treat deep vein thrombosis (DVT), which is a blood clot in a deep vein (usually in the thigh or lower leg)
- to treat pulmonary embolism (PE), which is a blood clot in the lungs
- to help lower the risk of getting another DVT or PE
- to prevent DVT and PE after hip or knee replacement surgery
- to prevent venous thromboembolism (VTE), another type of blood clot in a deep vein, in people hospitalized for an illness
- to help lower the risk of blood clots and stroke in people with atrial fibrillation (AFib) that isn’t caused by a heart valve problem
- to help lower the risk of cardiovascular events (such as heart attack and stroke) in people with coronary artery disease (CAD) or peripheral artery disease (PAD)
This article describes the dosages of Xarelto, including its form, strengths, and how to take the drug. To learn more about Xarelto, see this in-depth article.
Note: This article covers Xarelto’s typical dosages, which are provided by the drug’s manufacturer. But when using Xarelto, always take the dosage that your doctor prescribes.
What is Xarelto’s dosage?
Read on to learn more about the dosages of Xarelto that are typically prescribed.
What is Xarelto’s form?
Xarelto comes as tablets that you swallow.
What should I know about Xarelto’s strengths (2.5 mg, 10 mg, 15 mg, 20 mg)?
Xarelto comes in four strengths: 2.5 milligrams (mg), 10 mg, 15 mg, and 20 mg. The strength of Xarelto you take will depend on the condition you’re trying to prevent or treat.
What are the typical dosages of Xarelto?
Typically, your doctor will start you on a therapeutic dose of Xarelto. (“Therapeutic” refers to the amount of drug that’s needed to treat your condition.) Then they’ll monitor your condition over time to make sure the drug is working for you. Your doctor will ultimately prescribe the lowest dosage that provides the desired effect.
The normal dosage for Xarelto depends on the drug’s indication (the condition the drug is used to prevent or treat). The information below describes dosages that are commonly recommended for each use. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for treating DVT and PE
Xarelto can be used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is a blood clot in a deep vein, usually in the thigh or lower leg. PE is a blood clot in the lungs.
For this purpose, the usual dosage of Xarelto is 15 mg twice each day for 21 days. Then the dose is lowered to 20 mg once each day.
For treating DVT or PE, you may take Xarelto for 6 to 12 months.
Dosage for reducing the risk of getting another DVT or PE
If you’ve had a DVT or PE in the past, Xarelto can be used to help lower your risk of getting either again.
The typical dosage of Xarelto for this use is 10 mg once each day.
You would start Xarelto after at least 6 months of using an anticoagulant drug (blood thinner).
Dosage for preventing DVT and PE after hip or knee replacement
If you have a hip or knee replacement surgery, Xarelto can be used to prevent DVT or PE from happening afterward.
The usual dosage of Xarelto for this purpose is 10 mg once each day.
How long you’ll take Xarelto depends on the type of surgery you had. If you have knee replacement surgery, you’ll likely take the drug for 12 days afterward. Following a hip replacement, you’ll likely take it for 35 days.
Dosage for preventing VTE in people who are hospitalized for an illness
In people who are hospitalized for an illness, Xarelto can be used to prevent venous thromboembolism (VTE), a type of blood clot in a deep vein.
When used for this purpose, the typical dosage of Xarelto is 10 mg once each day. If you’re using Xarelto to prevent VTE during a hospital stay, you’ll likely take it for 31 to 39 days.
Dosage for reducing the risk of stroke and blood clots in people with AFib
If you have atrial fibrillation (AFib) that isn’t caused by a heart valve problem, Xarelto can help lower your risk of blood clots and stroke.
The usual dosage of Xarelto for this purpose is 20 mg once each day with your evening meal.
Dosage for reducing the risk of cardiovascular events in people with CAD or PAD
Xarelto can be used to help lower the risk of cardiovascular events (such as heart attack and stroke) in people with coronary artery disease (CAD) or peripheral artery disease (PAD).
For this purpose, the typical dosage of Xarelto is 2.5 mg twice each day.
Dosage before surgery
Taking Xarelto can increase your risk for bleeding. For this reason, you may need to temporarily stop taking Xarelto before a planned surgery.
Your doctor will likely recommend that you stop taking Xarelto at least 24 hours before surgery. But don’t stop taking the drug without talking with your doctor first. They’ll tell you whether you should stop taking Xarelto and give you instructions for the safest way to do so.
Dosage for people with kidney problems
Before your doctor prescribes Xarelto, they’ll likely give you kidney function tests. This is to make sure that your kidneys are working properly.
If your kidneys aren’t working properly, your doctor may not prescribe Xarelto. Or they might prescribe a lower dosage for you. This depends on the condition that you’re taking Xarelto to prevent or treat.
If you have kidney problems and have questions about the dosage that’s right for you, talk with your doctor.
Is Xarelto used long term?
In certain situations, Xarelto is meant to be used as long-term treatment.
The reason you’re taking Xarelto will determine how long you’ll take the drug. Listed below are the usual lengths of treatment for short-term uses of Xarelto. However, be sure to take the drug for the amount of time that your doctor recommends.
|Reason for taking Xarelto||Length of Xarelto treatment|
|to treat DVT or PE||for 6 to 12 months|
|to prevent DVT or PE after hip replacement surgery||for 12 days after your surgery|
|to prevent DVT or PE after knee replacement surgery||for 35 days after your surgery|
|to prevent VTE during hospitalization for an illness||for 31 to 39 days after being admitted to the hospital|
Xarelto is meant to be used as a long-term treatment when prescribed to help lower the risk of blood clots, heart attack, and stroke. If you and your doctor determine that Xarelto is safe and effective for you, it’s likely that you’ll use it long term for these purposes.
Your doctor may adjust your Xarelto dosage based on several factors, such as having kidney problems or a planned surgery.
For more information, see “Dosage before surgery” and “Dosage for people with kidney problems” above.
Frequently asked questions
Below are answers to some common questions about Xarelto.
Does my dosage affect the side effects I might have from Xarelto?
Studies of Xarelto didn’t look at the differences in side effects between higher and lower dosages of the drug. For most people, the Xarelto dosages recommended by the drug’s manufacturer are the lowest ones that provide the desired effects.
Taking a lower dosage than you are prescribed might cause the drug to be less effective for you. On the other hand, taking a higher dosage of Xarelto than you are prescribed can raise your risk for side effects from the drug.
Always take the dosage that your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
If you’re concerned about your risk for side effects from Xarelto, talk with your doctor.
Is there a specific dosage of Xarelto for older adults?
No, there isn’t a specific dosage of Xarelto for older adults. The dosages for older adults are generally the same as those for younger adults.
However, older people may have certain health conditions that affect their dosage of Xarelto. For example, older people may have a higher risk for kidney problems that could lead to a dosage adjustment.
If you’re an older adult with questions about what dosage of Xarelto is right for you, talk with your doctor.
Should I take my Xarelto doses with food?
The strength of Xarelto you’re prescribed will determine whether you take the drug with food.
If you’re prescribed the 2.5-milligram (mg) or 10-mg Xarelto tablets, you’ll take your doses with or without food. If you’re prescribed the 15-mg or 20-mg Xarelto tablets, you’ll take each dose with food.
What factors can affect my dosage?
The dosage of Xarelto you’re prescribed may depend on several factors. These include:
- the type and severity of the condition you’re using Xarelto to treat
- other conditions you may have (see “Dosage adjustments” under “What is Xarelto’s dosage?”)
How is Xarelto taken?
Your reason for taking Xarelto and the strength you’re prescribed will help determine how you take the drug.
You’ll likely take Xarelto either once or twice each day.
For most conditions treated with a once-daily dose of Xarelto, you can take your dose at any time of day. Try to take it at the same time each day to keep consistent levels of the drug in your body.
If you’re taking Xarelto because you have atrial fibrillation (AFib), you should take your once-daily dose with your evening meal.
For conditions that require taking Xarelto twice per day, you should take one dose in the morning and one in the evening. Generally, you’ll separate your morning and evening doses by about 12 hours. Try to take your doses at the same times each day.
If you’re taking the 2.5-mg or 10-mg Xarelto tablets, you can take your dose with or without food. But if you’re taking the 15-mg or 20-mg Xarelto tablets, you should take each dose with food.
If you have questions about how to take Xarelto, talk with your doctor.
What if I miss a dose?
It’s important that you don’t miss a dose of Xarelto. Missed doses can increase your risk for blood clots. Xarelto has a
If you do miss a dose of Xarelto, your usual dosage determines what you should do. Below are recommendations for how to handle a missed dose of Xarelto based on your normal dosage:
- If you normally take 2.5 milligrams (mg) of Xarelto twice each day, skip your missed dose. You can take your next dose at its usual time. Don’t take any extra dose of Xarelto to make up for your missed dose.
- If you normally take 15 mg of Xarelto twice each day, take your missed dose as soon as you remember. Then take your next dose at its usual time. If you miss a morning dose but don’t remember until it’s time for your evening dose, you can take two 15-mg tablets (a total of 30 mg) for your evening dose. Make sure your total daily dose doesn’t exceed 30 mg.
- If you normally take 10 mg, 15 mg, or 20 mg of Xarelto once each day, take your missed dose as soon as you remember. Then take your next dose at its usual time. Don’t take any extra doses of Xarelto to make up for your missed dose.
If you need help remembering to take your dose of Xarelto on time, try using a medication reminder. This can include setting an alarm, downloading a reminder app, or setting a timer on your phone. A kitchen timer can work, too.
What should be done in case of overdose?
Don’t use more Xarelto than your doctor prescribes. Taking more than this can lead to serious side effects.
Symptoms of overdose
Overdose can cause excessive bleeding. Symptoms of excessive bleeding can include:
- bloody or black stool
- bloody urine
- bruising more easily than usual
- coughing up blood
- frequent nosebleeds
- vomiting blood or a substance that looks like coffee grounds
What to do in case you take too much Xarelto
Call your doctor right away if you think you’ve taken too much Xarelto. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use their online resource. However, if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.
What should I ask my doctor
The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Xarelto for you, they will prescribe the dosage that’s right for you.
Remember, you shouldn’t change your dosage of Xarelto without your doctor’s approval. Take Xarelto exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions that you may want to ask your doctor:
- Should my dosage of Xarelto change if I eat certain foods?
- Do I have any health conditions that could affect my dosage of Xarelto?
- Should my Xarelto dosage change if I have a planned surgery?
- Will I need any blood tests to determine my dosage of Xarelto?
If you use Xarelto for atrial fibrillation (AFib), check out Healthline’s online AFib newsletter.
Ask a pharmacist
I have trouble swallowing Xarelto tablets whole. Can I split the tablets in half? Or can I crush them and mix them with food or a drink?
Yes, you can split or crush Xarelto tablets. If you have trouble swallowing a tablet, you can crush it and mix it with applesauce to make it easier to take.
If you’re taking a 15-milligram (mg) or 20-mg dose of Xarelto, you should still eat afterward. You don’t need to eat after taking the 2.5-mg or 10-mg tablets.
Victor Nguyen, PharmD, MBAAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Disclaimer: Healthline 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.