Rivaban 2.5 mg Tablet

Oral factor Xa inhibitor anticoagulant for:

• Prevention of stroke and systemic embolism in non-valvular atrial fibrillation
• Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrence
• Prevention of DVT after hip or knee replacement surgery
• With aspirin (low dose 2.5 mg twice daily) in coronary or peripheral artery disease to prevent cardiovascular events

Atrial fibrillation: 20 mg once daily with the evening meal; 15 mg once daily if CrCl 15–49 ml/min.

DVT/PE treatment: 15 mg twice daily with food for 21 days, then 20 mg once daily with food (≥ 3 months); after 6 months, 10 or 20 mg once daily for extended prevention.

After hip/knee replacement: 10 mg once daily (with or without food), starting 6–10 hours after surgery, for 5 weeks (hip) or 2 weeks (knee).

Coronary/peripheral artery disease: 2.5 mg twice daily with aspirin 75–100 mg.

• 15 mg and 20 mg tablets must be taken with food (absorption).
• Missed dose: take the same day; do not double. Do not stop without medical advice (stroke/clot risk).

• Active clinically significant bleeding; lesions with high bleeding risk (recent brain bleed, GI ulcer)
• Liver disease with coagulopathy (Child-Pugh B/C)
• CrCl below 15 ml/min
• Mechanical heart valves, antiphospholipid syndrome (especially triple-positive) — use warfarin instead
• Use with other anticoagulants (except when switching)
• Pregnancy and breastfeeding

Common: bleeding — nosebleeds, gum bleeding, bruising, heavy periods, blood in urine, gastrointestinal bleeding; anaemia, dizziness, nausea, itching, raised liver enzymes.

Rare but serious: major bleeding (brain, stomach), spinal/epidural haematoma after spinal procedures, severe skin reactions, liver injury.

• Report black stools, blood in vomit or urine, severe headache, unusual bruising or prolonged bleeding.
• Kidney function before starting and at least yearly.
• Tell surgeons/dentists; usually stopped 24–48 hours before procedures.
• Carry an anticoagulant alert card.

Contraindicated in pregnancy and breastfeeding — use effective contraception; low-molecular-weight heparin is used in pregnancy.

• Ketoconazole, itraconazole, voriconazole, ritonavir (greatly raise levels — avoid)
• Rifampicin, carbamazepine, phenytoin, St John's wort (reduce effect — avoid)
• Aspirin, clopidogrel, NSAIDs, SSRIs, other anticoagulants (bleeding)
• Clarithromycin, erythromycin, dronedarone (raise levels — caution)

Bleeding. Activated charcoal if early; andexanet alfa or prothrombin complex concentrate may be used in hospital.

Store below 30°C.