When is the best time to take Xarelto? (3+tip)

In this article, we will discuss the optimal timing for taking Xarelto. Additionally, we will explore various research findings related to the dosage schedule of Xarelto, its side effects, and precautions to take while on Xarelto therapy.

When is the best time to take Xarelto? 

Xarelto is usually prescribed in the evening once daily. However, sometimes, the dosing schedule may vary. The dosage of Xarelto can be split into two and administered in the morning and at night. The decision to split the dosage should depend on the patient’s condition and response to the drug. Studies have shown that taking Xarelto in the evening increases its effectiveness and prolongs the stay of the drug in the body. (1)

Xarelto is an anticoagulant which helps prevent clots in your system. It is important to follow the directions of your physician; if your physician has prescribed Xarelto twice a day, take it as it is and do not alter the course of treatment without any guidance from your physician, as it can lead to complications. (2)

Always complete the treatment course of anticoagulants to avoid life-threatening conditions such as stroke, myocardial infarction and restricted blood flow to a particular part of the body. 

What does the research suggest? 

One of the research studies done by Ziegler et al. mentioned that a single dose of Xarelto given in the evening led to prolonged drug concentration in the body when compared to the dose of Xarelto given in the morning. The study says that there is a relationship between circadian rhythm, hypercoagulability and hypofibrinolysis. (1)

In this study, both male and female groups were included, who were divided into groups and given a single dose of Xarelto in the morning and evening. The outcome of the study showed that the concentration of Xarelto was higher after 12 hours following the evening dose administration when compared to 12 hours after the morning dose. Hence, the study concluded that taking Xarelto in the evening can be beneficial. (1)

However, the effect of the drug may differ among patients due to individual variabilities. Hence, it is important to follow the instructions given by your physician. 

When not to take Xarelto? 

Xarelto is not recommended if you are allergic. Suppose you experience any hypersensitivity reaction, which includes face swelling, itching, difficulty breathing, rashes, blisters, etc. Stop taking the drug and seek immediate medical help immediately. (2)

Xarelto is not recommended for conditions such as antiphospholipid syndrome. Patients with this condition have reported an increased rate of recurrent thrombotic events when treated with Xarelto. (2)

Xarelto is not recommended in patients who have moderate to severe hepatic impairment or in patients who have a condition which can cause coagulopathy. Xarelto is used with caution in patients with renal impairment and avoided in patients with end-stage renal disease to avoid complications. Xarelto is metabolised and excreted through the liver and kidneys, and any damage to these organs can increase the concentration of the drug in the body and cause toxicity. (2)

Xarelto is avoided in patients with prosthetic heart valves, rheumatic heart disease, mechanical valves and severe mitral stenosis. Do not take Xarelto if you have any bleeding disorder, active GI ulcers, vascular retinopathy, bronchiectasis, or any active bleeding. Tell your physician about your condition or any active bleeding to avoid the risk of heavy bleeding. (2)

What things you should know about Xarelto and its dosing? 

Xarelto is a blood thinning agent that helps prevent clot formation and blockage of the arteries and veins. 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 the blood supply to a particular part of the body. (2)

Xarelto is typically prescribed once a day in the evening, although the dose of Xarelto may vary and can be prescribed twice daily. The dose of Xarelto ranges from 2.5mg to 25mg. It is important to consume Xarelto exactly as prescribed by your physician. 

Do not stop taking the medication before completion of the treatment course because 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. 

What are the precautionary measures to take while on Xarelto? 

It is important to follow certain measures when taking Xarelto to ensure safe and effective use, such as: 

• Take Xarelto as prescribed by your physician, and do not change the course of your treatment without first consulting your physician. 
• Avoid taking any over-the-counter medication without consulting your physician. Some of the drugs, such as NSAIDs (ibuprofen, naproxen), aspirin, etc., can interact with Xarelto and increase the risk of bleeding. 

• Xarelto also interacts with antidepressants (sertraline, fluoxetine), antifungals (ketoconazole, itraconazole), seizure drugs (phenytoin), etc. 
• Avoid taking herbal supplements without a physician’s guidance because herbal drugs such as St. John’s wort, ginkgo, etc, can interact with Xarelto and increase the risk of bleeding. 

• Avoid eating grapefruit, ginger, cinnamon, etc., as it can increase the risk of bleeding.  
• Avoid activities that pose a risk of injury and bleeding.
• Avoid taking a double dose of Xarelto, as it can increase the risk of bleeding.
• If you missed a dose of Xarelto, take it as soon as possible on the same day. Do not take a high double dose of Xarelto at the same time. If you have been prescribed 2.5 mg of Xarelto twice a day and you missed your morning dose, you can take two 2.5 mg tablets in the evening to meet the required dose of the drug for the day. 

• If you experience any discomfort while taking Xarelto or have uncontrolled bleeding, seek medical help immediately. 
• It is important to attend all follow-up appointments to monitor treatment and adverse effects.

In my experience

As far as I know, Xarelto is more effective when taken in the evening than in the morning. However, the effect of the drug may differ between individuals. Always take the drug as prescribed by your physician, and if you experience any discomfort, make sure you consult your physician. 

References