Rivaroxaban

Category: pharmacological

Aliases: Xarelto, BAY 59-7939

Pharmacological Mechanism

Selective, reversible direct FXa inhibitor. First DOAC approved. Once-daily dosing in AF reflects the receptor binding profile rather than plasma t½ (t½ ~7–11 h would otherwise suggest BID). Andexanet alfa specific reversal available.

Half-Life (t½)

PO: 10.7h

Dosing Guidelines

• PO: Typical 20 mg (Range: 20–20 mg)

Target Organ Systems

• immune-hematologic
• cardiovascular

Interactions

• Apixaban (caution): Same class; do not combine. Pick one DOAC.
• Warfarin (caution): Do not combine; overlapping anticoagulation.
• NSAIDs (caution): Additive GI bleed risk; avoid chronic co-use. [Holbrook 2005]

Pathways It Modulates

• Coagulation cascade (inhibitor) — factor Xa (direct)

Chemical Identifiers

• PubChem CID: 9875401
• Formula: C19H18ClN3O5S
• Molecular weight: 435.88 g/mol
• InChIKey: KGFYHTZWPPHNLQ-AWEZNQCLSA-N
• SMILES: C1COCC(=O)N1C2=CC=C(C=C2)N3C[C@@H](OC3=O)CNC(=O)C4=CC=C(S4)Cl

References

• PMID 23999929
• PMID 15911722
• PMID 15748242