What happens if you accidentally take two Xarelto? (3+tips)

In this article, we will discuss the consequences of taking two Xarelto at the same time. We will also discuss the side effects and the measures to take if you have accidentally taken two Xarelto. 

What happens if you accidentally take two Xarelto?  

If the dose of Xarelto is higher than usual, it will increase the risk of severe bleeding. You may experience heavy bleeding, easy bruising, brain haemorrhage (bleeding in the brain), etc. If you have accidentally consumed a double dose of Xarelto, make sure you consult your physician for a proper intervention. 

Avoid participating in any activities that pose a risk of injury. Xarelto is an anticoagulant that prevents clotting. Blood clotting is an essential process to avoid the risk of excessive bleeding upon an injury. When the process of clotting is hindered, it can result in uncontrolled bleeding, which can be life-threatening. (1)

Make sure you take the appropriate dose prescribed by your physician and seek immediate medical help in case of bleeding. 

What does the research study suggest? 

A study by Sajkov et al. reported a case of an accidental overdose of Xarelto (rivaroxaban) in a patient with a pulmonary embolism. The patient was prescribed 15mg twice daily of Xarelto for the treatment of venous thromboembolism, but the patient received two doses of 150 mg Xarelto 12 hours apart due to a writing mistake. (2)

This error was identified a few minutes after the 2nd dose of Xarelto. Immediate action was taken, and the patient was administered 50mg of charcoal. If charcoal is administered immediately, it reduces the absorption of direct oral anticoagulants (DOACs) apixaban and dabigatran by 50%. (2)

A 31-year-old female was prescribed Xarelto because of her history of myocardial infarction. She consumed 1,200mg of Xarelto in an attempt to commit suicide, following which she had abnormal lab findings. She was monitored closely for any side effects, and the necessary intervention was carried out. Sometimes, even those who consumed >1200mg of Xarelto d0 not have any bleeding episodes but were at a higher risk of bleeding. (3)

What are the interventions taken upon Xarelto’s overdose? 

If you have consumed a double dose of Xarelto, seeking medical help is necessary. With an increased dose of Xarelto, the risk of bleeding is also increased, which needs careful monitoring and intervention to avoid life-threatening conditions. 

Once a patient gets admitted to the hospital due to over-dosing of Xarelto, the immediate priority will be minimising the adverse effect. Here are some ways which are used to manage adverse events associated with overdosing on Xarelto. (1,2)

• Patients with minor bleeding are managed by skipping a single dose or delaying the time of Xarelto intake. 
• Patients with major bleeding are managed by antifibrinolytic agents. 
• For patients who present to the hospital within 1 or 2 hours after Xarelto overdose administration, activated charcoal is used to minimise the absorption of Xarelto. 
• The patients who have a high chance of experiencing life-threatening conditions are treated with andexanet alfa (antidote for rivaroxaban) or an unactivated 4-factor PCC. 

Do not try managing the symptoms of overdose caused by Xarelto at your home. Make sure you consult your physician for proper management. 

What are the things you should know while consuming Xarelto?  

Xarelto is a blood thinning agent that helps prevent clot formation and blockage of the arteries. Xarelto is used to reduce the risk of stroke associated with thromboembolism (blockage of arteries), cardiac arrhythmia and atrial fibrillation to prevent any blockage in the arteries or veins, which can cut blood supply to a particular part of the body. 

The dose of Xarelto ranges from 2.5mg to 20mg. Xarelto should be taken as prescribed by your physician at the same time of the day. Do not stop taking the medication before completing the treatment course, as it can increase the risk of stroke and embolism, which can be life-threatening. If you missed a dose of Xarelto, take it as soon as you remember on the same day and avoid double dosing of the drug. 

If you are planning to undergo any invasive procedure which involves cuts on your skin or dental surgery, make sure you inform the respective physician about your anticoagulant therapy to avoid excessive bleeding and complications. 

Always consult your physician before taking any OTC medication, as few of them can interact with Xarelto. There are a few prescription drugs which can interact with Xarelto, such as antidepressants (sertraline, fluoxetine), antipsychotics (phenytoin), herbal supplements (St. John’s wort), etc. 

In my experience

If you have consumed a double dose of Xarelto accidentally, look out for any adverse events such as bleeding, easy bruising, dizziness, headache, or drowsiness. If you experience any discomfort, consult a physician immediately. Avoid doing any heavy work or activities which contain an increased risk of bleeding or injury. You can use a pill organiser to help you take the right drug and dose. 

References