What should I do if I miss a dose of Xarelto (Rivaroxaban)?

What to Do If You Miss a Dose of Xarelto (Rivaroxaban)

If you miss a dose of Xarelto (rivaroxaban), take the missed dose as soon as you remember on the same day. Do not take a double dose to make up for a missed dose. 1

Specific Instructions Based on Dosing Regimen

For Once Daily Dosing:

• If you miss your dose, take it as soon as you remember on the same day 1
• Return to your regular dosing schedule the next day 1
• Never take two doses on the same day to make up for a missed dose 1

For Twice Daily Dosing:

• If you miss a morning dose, take it as soon as you remember and you may take it together with your evening dose 1
• If you miss an evening dose, you can only take it in the same evening (not the next day) 1
• For 15 mg twice daily dosing (30 mg total daily dose): You may take two 15 mg tablets at once to ensure the total daily intake of 30 mg 1

Important Considerations

Timing of Missed Dose:

• Take the missed dose as soon as possible once noticed, but only on the same day 1
• If it's already the next day, skip the missed dose and continue with your regular schedule 1, 2
• The goal is to maintain therapeutic blood levels without causing excessive anticoagulation 3

Risk Assessment:

• For patients with high thrombotic risk (CHA₂DS₂-VASc score ≥3), taking the missed dose is particularly important to maintain anticoagulation 3
• For patients with lower thrombotic risk (CHA₂DS₂-VASc score <2), waiting until the next scheduled dose may be reasonable if it's close to the next dosing time 3

Special Situations

If Uncertain About Dose Intake:

• For once-daily regimen: If you're unsure whether you've taken your dose and have high thrombotic risk, take another tablet and continue your planned schedule 3
• For twice-daily regimen: If uncertain, don't take another tablet, but continue with the next dose at the scheduled time 3

If Multiple Consecutive Doses Are Missed:

• Contact your healthcare provider immediately for guidance 1
• You may need more specific instructions based on your medical condition and risk factors 3

Common Pitfalls to Avoid

• Never double your dose except in specific situations for twice-daily regimens as directed above 1, 2
• Don't stop taking Xarelto without consulting your doctor, as this increases your risk of blood clots 1
• Don't take extra doses to "catch up" if you've missed multiple doses 1
• Avoid running out of medication - refill prescriptions before you run out 1

When to Seek Medical Advice

• If you've taken too much Xarelto, go to the nearest hospital emergency room or call your doctor immediately 1
• If you've missed multiple doses, contact your healthcare provider for guidance 1
• If you experience any signs of bleeding, seek immediate medical attention 1

Remember to take your medication as prescribed to maintain proper anticoagulation and reduce your risk of blood clots or stroke. Using pill organizers or medication reminder apps can help prevent missed doses 2.