My Drug Center

How Does Xarelto Work?

Thursday 28 April 2022
4 minute(s) read

Table of Contents

I. Xarelto Uses

II. Xarelto Mechanism of Action

III. How Fast Does Xarelto Work?

IV. How Long Does Xarelto Last?

Xarelto Uses

Xarelto has many uses and is often prescribed to treat and prevent blood clots. Brand-name and generic Xarelto use the same active ingredient, rivaroxaban, to reduce the risk of blood clots, stroke, and cardiovascular events in patients with atrial fibrillation (AFib), coronary artery disease (CAD), and peripheral artery disease (PAD). Xarelto is primarily used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE). If you have a history of these blood clot-related conditions, your doctor may also prescribe Xarelto to prevent future occurrences of DVT and PE.

Another common use for Xarelto is preventing blood clots after surgery. Certain procedures, such as a hip or knee replacement, increase your risk of blood clots during recovery. These surgeries often restrict movement as you recover, which makes blood clots more likely. In clinical trials, Xarelto has been shown to be more effective than other blood thinners in preventing venous thromboembolism (VTE). These trials primarily compared rivaroxaban 10 mg with enoxaparin 40 mg, concluding that once-daily use of rivaroxaban was superior in lowering the incidence rate of blood clots. [1] Visit a Canadian online pharmacy like MyDrugCenter to fill your prescription for less, or read on to learn how Xarelto works and how long the benefits of Xarelto last.

an illustration of a blood clot

Xarelto Mechanism of Action

Rivaroxaban is a direct-acting anticoagulant (DOAC), part of a newer generation of blood thinners with enhanced effectiveness. DOACs also boast fewer food interactions than traditional blood thinners, meaning Xarelto is much more convenient compared to drugs like warfarin. Specifically, Xarelto is a factor Xa inhibitor. Put simply, Xarelto works by preventing this clotting factor from working. Inhibiting the body’s clotting factors significantly reduces your risk of blood clots.

For the body to produce a clot, it needs to form thrombin and prothrombin. To do so, the body produces factor Xa, an important enzyme necessary for coagulation. This enzyme is powerful, and the body only needs a small amount of it to make thrombin. In fact, studies show that a single factor Xa molecule can assist in creating 1,000 thrombin molecules. [2] Because of factor Xa’s critical role in forming clots, inhibiting factor Xa is a highly effective method to reduce the risk of blood clots. 

a doctor assessing a patient’s leg

How Fast Does Xarelto Work?

Xarelto effectively prevents clots by inhibiting factor Xa, but how quickly does Xarelto begin to work? How fast Xarelto works varies depending on whether they take Xarelto 10 mg, 15 mg, or 20 mg. The best way to take Xarelto will depend on your health condition, so always follow your doctor's directions. In clinical studies, researchers have proven the quick onset time of rivaroxaban, citing a rapid working time of two to four hours. [3] The rapid onset of Xarelto means that this anticoagulant will lower your risk of blood clots almost right away after dosing. While the benefits occur quickly, side effects may happen quickly as well. It is important to be aware that your risk of bleeding goes up once you take rivaroxaban. 

It is also important to know that certain factors can delay Xarelto’s onset time. For example, drug interactions can affect the levels of rivaroxaban in the system and delay Xarelto’s activation time. Conversely, certain drug interactions can make rivaroxaban too potent. Rivaroxaban is metabolized by the CYP3A4 enzyme, so any drug that inhibits this enzyme can cause dangerous concentrations of rivaroxaban to build up in the body. In the same study, researchers recommended avoiding azole antimycotics and protease inhibitors to ensure Xarelto works effectively. [3]

a hand holding a stopwatch

How Long Does Xarelto Last?

Once again, the dosage strength of Xarelto will affect how long it lasts in the body. Patients with non-valvular AFib are generally prescribed 20 mg once a day to prevent and lower the risk of stroke. Xarelto 10 mg is often used to prevent blood clots in general. Whether you take Xarelto with or without a meal will also contribute to the blood thinner’s onset and working time.

The stronger doses of 15 mg and Xarelto 20 mg should be taken with food, preferably during an evening meal. Taking these doses of Xarelto with food enhances the bioavailability of this anticoagulant for maximum effectiveness. The 10 mg dose is not affected by food, so you can take this dose with or without a meal. As a guideline, Xarelto has a half-life of approximately five to nine hours in most patients. In older populations, Xarelto may have a longer half-life of 11 to 13 hours. [4] According to these half-life times, the effects of Xarelto begin wearing off after a day but can stay in the system for about two days. For more information about maximizing the efficacy of this anticoagulant, take a look at MyDrugCenter's Xarelto blog page today.


DISCLAIMER: 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.