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Rivaroxaban: Drug & Food Interactions

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Rivaroxaban is a medication used to treat or prevent the formation of blood clots. In this lesson, we will learn about this drug and what food and other medications may place an individual taking rivaroxaban at an increased risk for bleeding.

Discharged with New Medication

Stan is appreciative of the care he received while in the hospital but is excited to get home. Learning he would be discharged in about an hour, he packs up his belongings hurriedly and doesn't pay attention to much else. His nurse encourages him to sit down and review his discharge instructions and information about his new medication. Unfortunately, he is too anxious and distracted to pay attention to the information the nurse attempts to share.

When he gets home, he realizes that he started a new medication called rivaroxaban. Only able to remember that the medication is used to prevent the formation of blood clots, he waits to ask questions about the drug until his follow-up appointment the next day.

What is Rivaroxaban?

At his appointment, the physician explains that rivaroxaban is a blood thinning medication that can dissolve or prevent the formation of blood clots. Stan learns that he is currently on the medication because he developed a pulmonary embolism, a blood clot in one of his lungs, during his stay in the hospital. Rivaroxaban may also be used to treat actual clots or help prevent them in people with:

  • Diagnosis of atrial fibrillation, an irregular heart rate that increases the risk of clot development in the heart
  • History of stroke
  • Smoking
  • Obesity

To prevent the development of further life-threatening clots within his body, the physician explains to Stan that he will likely be taking rivaroxaban for quite some time.

Learning More about Rivaroxaban

Before Stan leaves the office, the physician teaches him essential information regarding rivaroxaban. In order for the drug to remain therapeutic and effective, he must pay close attention to how food and his other drugs may interact with the rivaroxaban.

Food Interactions

Ginger may cause an increased risk of bleeding in people who take rivaroxaban.
Ginger may cause an increased risk of bleeding in people who take rivaroxaban.

Not realizing that food may interact with his new medication, Stan was surprised to learn that drastic dietary changes should not be made. He received a list of food substances that should be avoided in large quantities due to their ability to increase his risk of bleeding:

  • Ginger
  • Garlic
  • Ginkgo
  • Horseradish

He also learns that he does not need to take his low dose of rivaroxaban with food. If his dose were to be increased, however, he would then be encouraged to take it with food. Large doses of rivaroxaban are better absorbed into the body when taken during meals.

Drug to Drug Interactions

Because rivaroxaban prevents clots from forming, Stan is at high risk for bleeding if he were to get injured or need an emergency medical procedure. Combining his new drug with his daily aspirin increases this risk. Other drugs combined with rivaroxaban also create a greater risk for bleeding may include:

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