From the Guidelines
Taking Xarelto (rivaroxaban) every other day instead of daily is not recommended and lacks supporting research. Xarelto is specifically designed and FDA-approved for daily dosing (either once or twice daily depending on the condition being treated) to maintain consistent blood levels for effective anticoagulation. There are no published clinical trials evaluating alternate-day dosing of Xarelto, as stated in the studies 1. The medication has a half-life of 7-11 hours, meaning blood levels would drop significantly between doses if taken every other day, potentially leaving patients unprotected from clot formation 1. This could increase the risk of serious events like stroke or pulmonary embolism.
Some key points to consider:
- Xarelto is not recommended for use in patients with severe renal failure and a creatinine clearance of 15 mL/min or less 1.
- The dosage of Xarelto may need to be adjusted in patients with renal impairment, with a recommended dose of 15 mg once daily for patients with a creatinine clearance between 15 and 30 mL/min 1.
- Insurance typically won't cover non-standard dosing regimens, potentially increasing out-of-pocket costs.
- If you're concerned about Xarelto's cost or side effects, speak with your healthcare provider about FDA-approved alternatives rather than modifying the dosing schedule yourself, as this could compromise your safety and treatment efficacy.
It's essential to follow the recommended dosing schedule for Xarelto to ensure effective anticoagulation and minimize the risk of adverse events. Any changes to the dosing regimen should be made under the guidance of a healthcare provider, taking into account individual patient factors and the latest clinical evidence 1.
From the Research
Risks and Benefits of Taking Xarelto Every Other Day
- There is no direct evidence in the provided studies to support the efficacy and safety of taking Xarelto every other day rather than daily 2, 3, 4, 5, 6.
- The standard dosing regimen for Xarelto is once daily, and this has been shown to be effective in preventing thromboembolic complications 4, 6.
- A study comparing twice-daily and once-daily dosing regimens of novel oral anticoagulants found that twice-daily dosing may offer a more balanced risk-benefit profile with respect to stroke prevention and intracranial hemorrhage 5.
- However, this study did not investigate the efficacy and safety of taking Xarelto every other day, and it is unclear whether this dosing regimen would be effective and safe.
Efficacy of Xarelto
- Xarelto has been shown to be effective in preventing thromboembolic complications in patients with nonvalvular atrial fibrillation 4, 6.
- The EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for the treatment of venous thromboembolism 2.
- Xarelto has also been shown to be effective in patients with moderate renal dysfunction and those with ischemic heart disease 6.
Safety of Xarelto
- Xarelto has been shown to be safe and well-tolerated in clinical trials 2, 4, 6.
- The risk of intracranial hemorrhage was lower with Xarelto compared to warfarin in some studies 5.
- However, the safety of taking Xarelto every other day is unknown, and this dosing regimen may increase the risk of thromboembolic complications or other adverse events.