My Drug Center

5 Side Effects of Xarelto in the Elderly

Monday 13 November 2023
6 minute(s) read

Table of Contents

I. What is Xarelto?

II. General Side Effects of Xarelto

III. Xarelto Side Effects Specific to Elderly Patients

IV. Managing the Risks of Xarelto Side Effects

V. Save On Your Next Xarelto Prescription

Xarelto is a staple medication for preventing blood clots and strokes, especially in elderly patients. However, side effects of Xarelto in the elderly can also occur more frequently and be more severe, meaning there is an increased need to actively manage and prevent their potential occurrence.

In this article, we’ll cover common Xarelto side effects and how they specifically impact elderly individuals, plus the important steps patients can take to reduce their risk. By understanding both, those taking Xarelto can manage it with confidence, ensuring the highest safety and quality of life possible.

Quick Takeaways:

  • Xarelto is a direct oral anticoagulant prescribed to prevent blood clots and strokes.
  • Like all medications, Xarelto comes with side effects. These include increased risk of bleeding and impacted kidney function, among others.
  • Elderly patients are at elevated risk of side effects due to natural age-related conditions.
  • It’s critical for elderly patients taking Xarelto to manage and prevent side effects in partnership with their healthcare provider.

What is Xarelto?

Xarelto (generic name rivaroxaban) is an anticoagulant medication that's part of the newer class of blood thinners called direct oral anticoagulants (DOACs). Primarily prescribed to prevent blood clots and strokes, Xarelto is often taken by patients with atrial fibrillation as well as those undergoing hip or knee replacement surgeries.

Xarelto’s key function is to inhibit Factor Xa, an enzyme crucial to the blood clotting process, thereby reducing the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation.

Graphic showing the mechanism Xarelto executes to inhibit Factor Xa


For the elderly population, Xarelto's appeal lies in its straightforward usage compared to traditional blood thinners, which often require regular blood tests to monitor their effects. The medication promises a fixed dosing regimen without the need for frequent adjustments, simplifying blood clot prevention for older adults who may have complex medication schedules.

That said, understanding the nuances of Xarelto, including its side effects, is particularly important in this age group due to its increased susceptibility to complications.

General Side Effects of Xarelto

Xarelto, like all medications, carries the potential for side effects, which can range from mild to severe. Commonly reported side effects of Xarelto include bleeding complications, which are the most significant due to Xarelto's primary action of blood thinning.

Patients may notice symptoms like unusual bruising, prolonged bleeding from cuts, increased menstrual flow, or bleeding gums. Additionally, some may experience gastrointestinal issues such as stomach pain, indigestion, or nausea.

More infrequent side effects include headaches, dizziness, or allergic reactions, which can present as itching, rashes, or more serious manifestations like anaphylaxis. Since Xarelto can impact kidney function, patients may also notice changes in the frequency or output of urine, signaling a more serious condition.

In rare cases, Xarelto has been associated with liver injury, evidenced by symptoms like fatigue, yellowing of the skin or eyes, and dark urine.

It's crucial for individuals taking Xarelto to know these side effects and have open communication with their healthcare providers about any new or worsening symptoms. Prompt recognition and management of side effects can significantly influence the overall safety and efficacy of the treatment with Xarelto.

Xarelto Side Effects Specific to Elderly Patients

The elderly population often faces a greater risk of side effects from medications due to physiological changes that occur with aging, and Xarelto is no exception. Understanding these risks can help manage and mitigate potential complications.

Increased Risk of Bleeding

Older adults may experience more intense and longer-lasting bleeding events. Factors like fragile skin, preexisting conditions, and concurrent use of other medications that affect blood clotting can exacerbate this risk.

Gastrointestinal Bleeding

There is a heightened concern for gastrointestinal bleeding in elderly patients taking Xarelto, which can present as stomach pain, blood in the stool, or black, tarry stools.

Renal Function Considerations

Age-related decline in kidney function can affect how Xarelto is processed in the body, potentially leading to higher levels of the drug in the bloodstream and an increased risk of side effects. Regular kidney tests are crucial for elderly patients on Xarelto to ensure the drug is being eliminated appropriately.

Drug Interactions

The elderly are more likely to be on multiple medications, increasing the risk of drug interactions that can enhance the side effects of Xarelto. Blood pressure medications, antiplatelets, and NSAIDs are a few of the common medications taken by older adults that can interact with Xarelto and increase the risk of side effects occurring.

Cardiac and Hematologic Concerns

Older patients with existing heart conditions may be at a higher risk for cardiac-related side effects when taking Xarelto.

Managing the Risks of Xarelto Side Effects

Effectively managing the risks of side effects associated with Xarelto, particularly for the elderly, involves proactive strategies and vigilant monitoring to mitigate the potential for adverse effects. This requires steps like:

Regular Medical Supervision

Frequent appointments with healthcare providers are imperative for elderly patients on Xarelto in order to monitor for any changes that could indicate side effects. Although Xarelto does not typically require routine blood monitoring, in the case of the elderly, periodic tests may be beneficial to check for signs of over-anticoagulation, kidney function, and overall blood cell counts.

Personalized Dosing Regimens

Dosage should be determined on an individual basis, taking into account factors such as kidney function, body weight, and overall health status. Dosages may need adjustment over time as the patient's health condition changes or if they experience side effects.

Education on Side Effects

Patients and caregivers should be educated on the signs of potential side effects, particularly bleeding, so they know when to seek immediate medical attention. Understanding how to manage the timing of Xarelto with other medications to avoid interactions is crucial.

Lifestyle Modifications

Simple home modifications to prevent falls, and the use of protective gear (ex: gloves for gardening or using knives while cooking), can reduce the risk of injuries that may lead to bleeding complications.

Emergency Preparedness

Wearing a medical alert bracelet indicating that they are taking an anticoagulant can be vital in case of an emergency where the patient cannot communicate.

By implementing these management strategies, the risks of Xarelto side effects in the elderly can be significantly reduced, promoting a safer treatment experience and better overall outcomes.

Save On Your Next Xarelto Prescription

In addition to managing Xarelto’s potential side effects, many elderly patients have another critical consideration to keep in mind: cost. Because Xarelto is a brand-name medication, it can come with high co-pays and out-of-pocket costs, even for patients with insurance or Medicare.

My Drug Center offers an affordable alternative, helping patients save up to 80% on prescriptions and providing the convenience of home delivery.

Learn how to save on your next Xarelto prescription today.

The information in the article is not meant to be used for treatment or diagnosis. It is designed for general awareness and for information purposes only. Always consult a medical professional for your specific healthcare needs.