Latest research on Xarelto

Rivaroxaban is an anticoagulant and the first orally active direct factor Xa inhibitor. Unlike warfarin, routine lab monitoring of INR is not necessary. However there is no antidote available in the event of a major bleed. Only the 10 mg tablet can be taken without regard to food. The 15 mg and 20 mg tablet should be taken with food. FDA approved on July 1, 2011.

Latest findings

Rivaroxaban (BAY 59-7939) was obtained directly from Bayer® pharmaceuticals (Germany) in aliquots containing 10 mg of rivaroxaban salt. [source, 2011]
A dose-ranging study of BAY 59-7939 (Rivaroxaban), a direct oral inhibitor of activated Factor X, was performed with total knee replacement patients [27]. [source, 2007]
Among the five BAY 59-7939 dose groups tested (2.5 mg, 5 mg, 10 mg, 20 mg, and 30 mg twice daily), the incidence of the primary efficacy endpoint ranged from 23.3% (10 mg twice daily) to 40.4% (5 mg twice daily). [source, 2007]
In a second dose-finding study of BAY 59-7939 in total hip replacement patients [28], there was a significant dose-dependent trend, with the highest dose yielding better efficacy than the lowest dose. [source, 2007]
Major postoperative bleeding was significant and dose-related (0.8%, 2.2%, 2.3%, 4.5%, and 5.4% for 2.5 mg, 5 mg, 10 mg, 20 mg, and 30 mg BAY 59-7939 twice daily, respectively). [source, 2007]
A third dose-ranging study with BAY 59-7939 administered as a single daily dose was recently published [29]. [source, 2007]
In all groups receiving BAY 59-7939, major postoperative bleeding occurred upon the first postoperative dose and was significant (p = 0.0391) and dose related. [source, 2007]
Taken together, the results of dose-finding studies of BAY 59-7939 lead to an interesting observation: it appears that higher doses increase the frequency of major postoperative bleeding events and are less effective in preventing venous thromboembolism compared to moderate doses. [source, 2007]
Rivaroxaban (Xarelto) was from Bayer and melagatran was a gift from AstraZeneca. [source, 2016]