What is the elimination half-life of Rivaroxaban (Xarelto) in a 66-year-old female?

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From the Guidelines

For a 66-year-old woman, Xarelto (rivaroxaban) has an elimination half-life of approximately 5-9 hours, with complete elimination generally occurring after 4-5 half-lives, which translates to around 24-48 hours 1. The half-life of rivaroxaban can vary depending on several factors, including age and kidney function. In elderly patients, the half-life of rivaroxaban can range from 5-9 hours 1.

Factors Affecting Elimination

  • Age: Older adults tend to clear the medication more slowly than younger individuals 1.
  • Kidney function: Rivaroxaban is partially eliminated through the kidneys, so reduced kidney function can impact clearance time 1.

Clinical Considerations

  • For medical procedures requiring complete elimination of anticoagulant effects, Xarelto is typically stopped 24-48 hours before the procedure, depending on the bleeding risk and the patient's kidney function 1.
  • It's essential to never stop taking Xarelto without medical guidance due to increased stroke risk, especially in patients taking it for atrial fibrillation.

Key Takeaways

  • The elimination half-life of rivaroxaban in a 66-year-old female is approximately 5-9 hours 1.
  • Complete elimination of rivaroxaban generally occurs after 4-5 half-lives, which is around 24-48 hours 1.
  • Kidney function and age are crucial factors affecting the elimination of rivaroxaban 1.

From the FDA Drug Label

The terminal elimination half-life is 11 to 13 hours in the elderly subjects aged 60 to 76 years The elimination half-life of Rivaroxaban (Xarelto) in a 66-year-old female is 11 to 13 hours 2.

From the Research

Elimination Half-Life of Rivaroxaban

  • The elimination half-life of Rivaroxaban is not directly stated in the provided studies for a 66-year-old female.
  • However, the pharmacokinetics of Rivaroxaban are discussed in several studies, including 3, which mentions that Rivaroxaban has a high peroral bioavailability and moderate pharmacokinetic variability.
  • Study 3 also states that the absorption of Rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration.
  • Additionally, study 4 discusses the impacts of concomitant verapamil administration and renal impairment on Rivaroxaban pharmacokinetics, but does not provide specific information on the elimination half-life.
  • Study 5 presents a case of a 68-year-old male patient who was receiving Rivaroxaban, but does not provide information on the elimination half-life in a 66-year-old female.
  • Study 6 summarizes current knowledge supporting the use of Rivaroxaban in patients with severe renal impairment, but does not provide specific information on the elimination half-life.
  • Study 7 is not relevant to the question as it discusses a case of a 66-year-old woman with disseminated intravascular coagulation, lactic acidosis, and hypoglycemia, but does not mention Rivaroxaban or its pharmacokinetics.

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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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