Is it safe to get a tattoo while taking Xarelto (rivaroxaban)?

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Last updated: April 14, 2025View editorial policy

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From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

It is generally not safe to get a tattoo while taking Xarelto (rivaroxaban). Xarelto is a blood thinner that prevents blood clots by inhibiting a specific clotting factor, which means you'll bleed more easily and for longer periods. Getting a tattoo involves repeated needle punctures that cause controlled skin trauma and bleeding. While on Xarelto, this bleeding may be excessive and difficult to control, potentially leading to significant bruising, prolonged bleeding, or hematoma formation. The increased bleeding can also affect the quality of the tattoo by diluting the ink and causing it to spread under the skin.

Risks Associated with Tattooing on Xarelto

  • Excessive bleeding
  • Prolonged bleeding
  • Hematoma formation
  • Significant bruising
  • Poor tattoo quality due to ink dilution and spread

If you're determined to get a tattoo, you should consult with the healthcare provider who prescribed your Xarelto to discuss options, which might include temporarily stopping the medication. However, stopping Xarelto requires careful medical supervision as it could increase your risk of developing blood clots, as noted in a case report where a patient experienced bleeding and coagulation abnormalities while on rivaroxaban 1. Never stop taking Xarelto without medical guidance. Most tattoo artists will also refuse to work on clients taking blood thinners due to these risks.

Management of Bleeding on Xarelto

Recent studies have investigated the management of bleeding associated with direct oral anticoagulants, including Xarelto. The development of specific reversal agents, such as andexanet alfa, has provided improved strategies for the management of bleeding in patients taking Xarelto 2. However, these agents are typically reserved for life-threatening or uncontrolled bleeding, and their use in the context of tattooing is not established.

In general, the risks associated with getting a tattoo while taking Xarelto outweigh any potential benefits, and it is recommended to avoid tattooing until the medication is stopped or an alternative anticoagulant is used, under the guidance of a healthcare provider. The safety of tattooing products and the potential long-term complications of tattooing, such as fibrosis, granulomatous changes, and systemic inflammation, should also be considered 3.

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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