What is the recommended dose of Xarelto (rivaroxaban) for treating deep vein thrombosis (DVT) and pulmonary embolism (PE)?

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Last updated: June 20, 2025View editorial policy

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From the Guidelines

For treating deep vein thrombosis (DVT) and pulmonary embolism (PE), the recommended dose of Xarelto (rivaroxaban) is 15 mg taken orally twice daily with food for the first 21 days, followed by 20 mg once daily with food for the remainder of the treatment. This dosing regimen is based on the most recent and highest quality study available, which demonstrated the efficacy and safety of rivaroxaban in the treatment of DVT and PE 1. The typical treatment duration is at least 3 months, but may be extended to 6-12 months or longer depending on the patient's risk factors for recurrence. It's essential to take Xarelto at the same time each day to maintain consistent blood levels. Patients should not stop taking the medication without consulting their healthcare provider as this could increase the risk of blood clots. Rivaroxaban works by inhibiting Factor Xa, a key component in the blood clotting cascade, thereby preventing the formation of new clots and the extension of existing ones. Common side effects include bleeding risk, so patients should report any unusual bleeding or bruising to their doctor immediately. Dose adjustments may be necessary for patients with kidney impairment, and Xarelto should be used cautiously in patients with liver disease.

Some key points to consider when prescribing Xarelto include:

  • The importance of taking the medication at the same time each day to maintain consistent blood levels
  • The need for regular monitoring of kidney function and liver function
  • The risk of bleeding and the importance of reporting any unusual bleeding or bruising to the doctor immediately
  • The potential for interactions with other medications, such as antacids and certain antibiotics

Overall, the use of Xarelto for the treatment of DVT and PE has been well-established in the medical literature, and its efficacy and safety have been demonstrated in numerous studies 1. However, it's crucial to carefully consider the individual patient's risk factors and medical history when prescribing this medication.

From the FDA Drug Label

Adults Advise patients for initial treatment of DVT and/or PE to take XARELTO 15 mg or 20 mg tablets with food at approximately the same time every day [see Dosage and Administration (2. 1)] .

Starter Pack for treatment of deep vein thrombosis and treatment of pulmonary embolism: NDC 50458-584-5130-day starter blister pack containing 51 tablets: 42 tablets of 15 mg and 9 tablets of 20 mg

The recommended dose of Xarelto (rivaroxaban) for treating deep vein thrombosis (DVT) and pulmonary embolism (PE) is:

  • 15 mg twice daily with food for the first three weeks, followed by 20 mg once daily with food 2 Alternatively, a Starter Pack is available, which contains 42 tablets of 15 mg and 9 tablets of 20 mg for a 30-day treatment period 2. Key points:
  • The dose should be taken with food at approximately the same time every day.
  • The treatment duration is 3,6, or 12 months based on the investigator's assessment prior to randomization 2.

From the Research

Xarelto Dose for Treating Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

  • The recommended dose of Xarelto (rivaroxaban) for treating DVT and PE is 15 mg twice daily for 21 days, followed by 20 mg once daily thereafter 3, 4, 5.
  • This dosing regimen has been shown to be effective and safe in a broad range of adult patients, including those with high risk of recurrent VTE 3.
  • For extended treatment, rivaroxaban can be given at a dose of 20 mg once daily or 10 mg once daily, depending on the patient's risk of recurrence, bleeding, and personal preferences 3.
  • The efficacy and safety of rivaroxaban have been demonstrated in several clinical trials, including the EINSTEIN-DVT and EINSTEIN-PE trials, which compared rivaroxaban with standard therapy consisting of enoxaparin and warfarin 4, 5.
  • Rivaroxaban has been shown to be noninferior to standard therapy in preventing recurrent VTE, with a significantly lower rate of major bleeding 4, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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