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Rivaroxaban (Xarelto)

Anticoagulantprescriptionoral · inferred

Direct oral anticoagulant (DOAC) and selective, reversible factor Xa inhibitor. Rapid absorption (tmax 2-4h) with high bioavailability (80-100%) especially when taken with food. Terminal half-life 7-11h (longer in elderly). Eliminated via renal (66%) and hepatic (33%) pathways; use with caution in renal impairment. No major pharmacologically active metabolites. Fixed dosing without monitoring. Approved for stroke prevention in nonvalvular atrial fibrillation, VTE treatment/prevention. More drug interactions than apixaban (CYP3A4/CYP2J2 substrate, P-gp substrate). Approximately 2.5-fold higher bleeding risk vs. warfarin in some trials.

Projected serum levels — 20 mg, once daily

Rivaroxaban (Xarelto)
Rivaroxaban (Xarelto) modeled serum levels, 20 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 5 10 15 20 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 20 mg once daily (oral).

Modeled steady state after ~1 days: peak ≈ 13.9 mg, trough ≈ 2.2 mg body load. Population-based estimate over 15 days for a 20 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Anticoagulant
Route modeled
Oral
Model confidence
inferred
Half-life
8 h
Common dose
20 mg
Suggested maximum
20 mg/day
Reference dose range
10–20 mg (single dose)
Suggested cadence
once daily
Validated against
20 mg oral — Cmax 0.27 mg/L at 3 h

Documented interactions

  • danger
    Carbamazepine (Tegretol) + Rivaroxaban (Xarelto) CYP induction

    Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~0.31x

  • danger
    Clarithromycin (Biaxin) + Rivaroxaban (Xarelto) CYP inhibition

    Clarithromycin (Biaxin) mechanism_based of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~2.03x

  • danger
    Diltiazem + Rivaroxaban (Xarelto) CYP inhibition

    Diltiazem mechanism_based of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~2.03x

  • danger
    Efavirenz (Sustiva) + Rivaroxaban (Xarelto) CYP induction

    Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~0.20x

  • danger
    Grapefruit (whole fruit) + Rivaroxaban (Xarelto) CYP inhibition

    Grapefruit (whole fruit) mechanism_based of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~2.03x

  • danger
    Grapefruit Juice + Rivaroxaban (Xarelto) CYP inhibition

    Grapefruit Juice mechanism_based of CYP3A4 predicted to change Rivaroxaban (Xarelto) AUC by ~2.03x

Serum checks 90 modeled interaction pairings for rivaroxaban (xarelto) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Clinical Pharmacokinetic and Pharmacodynamic Profile of Rivaroxaban Pinto DJ et al. · Clinical Pharmacokinetics, 2013 DOI

    Comprehensive PK/PD review showing rivaroxaban absorption (tmax 2-4h), bioavailability 80-100% with food, half-life 7-11h, renal/hepatic clearance, and FXa inhibition kinetics.

  2. Rivaroxaban: A New Oral Factor Xa Inhibitor Kearon C et al. · Arteriosclerosis, Thrombosis, and Vascular Biology, 2010 DOI

    Overview of rivaroxaban mechanism as selective FXa inhibitor, with predictable PK, food interaction, renal handling, and clinical efficacy data from phase II trials.

  3. Safety, pharmacokinetics and pharmacodynamics of single/multiple doses of the oral, direct Factor Xa inhibitor rivaroxaban in healthy Chinese subjects Wang L et al. · British Journal of Clinical Pharmacology, 2009 DOI

    Single/multiple ascending-dose study in healthy Chinese volunteers confirming linear rivaroxaban PK, no accumulation, dose-dependent FXa inhibition, good tolerability.

3 published studies referenced in the app, each with a plain-language summary.