Small molecule
PubChem CID 9875401
Rivaroxaban
Xarelto
- Mechanism of action
- Factor Xa inhibitor, blocks clotting cascade to reduce thrombin generation
- In plain language
- Blocks a clotting factor called Factor Xa, a key step in the chain reaction that forms blood clots, so blood clots less readily and existing clots are less likely to grow.
- How it works
- Rivaroxaban (Xarelto) is a selective inhibitor of Factor Xa (FXa). Per the FDA label, it does not require a cofactor such as antithrombin III for activity, and it inhibits both free FXa and prothrombinase activity. Rivaroxaban has no direct effect on platelet aggregation but indirectly inhibits platelet aggregation induced by thrombin; by inhibiting FXa, it decreases thrombin generation, producing dose-dependent inhibition of FXa activity and dose-dependent prolongation of clotting tests such as prothrombin time (PT) and activated partial thromboplastin time (aPTT).
- Therapeutic applications
- Rivaroxaban (Xarelto) is FDA-indicated to reduce the risk of stroke and systemic embolism in adults with nonvalvular atrial fibrillation; for treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and reduction of their recurrence risk after initial treatment; for prophylaxis of DVT after hip or knee replacement surgery and in acutely ill medical patients at risk for thromboembolic complications; and, in combination with aspirin, to reduce the risk of major cardiovascular events in patients with coronary artery disease and major thrombotic vascular events in patients with peripheral artery disease. It carries two boxed warnings: premature discontinuation of any oral anticoagulant, including rivaroxaban, increases the risk of thrombotic events; and epidural or spinal hematomas, which may result in long-term or permanent paralysis, have occurred in patients on rivaroxaban who receive neuraxial anesthesia or undergo spinal puncture.
- Class
- Small molecule
- Therapeutic area
- Anticoagulant
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