In 2020, the CDC reported that 13% of Americans had either started or increased their substance use. (1) Among military veterans, psychotherapeutic drugs are the most misused. (2) Xarelto, also known by its generic name, rivaroxaban, is a medication prescribed for blood thinning and to treat blood clots.
Rivaroxaban misuse can include:
- Taking higher doses than medically necessary or prescribed
- Taking for longer than a doctor has authorized
- Taking doses outside of the dosing schedule
- Crushing and snorting the powder form of rivaroxaban
Misusing Xarelto poses the risk of internal bleeding and hemorrhage that isn’t reversible. It can even permanently paralyze the user.
Rivaroxaban and other anticoagulants are considered high-risk and pose drug safety problems. The use of Xarelto can increase the risk of life-threatening complications and increase addiction risk. (3)
What Are the Common Side Effects of Rivaroxaban?
In the treatment groups studied, 60% to 80% of participants experienced at least one harmful reaction that required a trip to the emergency room.
Aside from bleeding, some side effects of Xarelto or rivaroxaban can also cause: (10)
- Headaches
- Cough
- Bruising
- Extremity pain
- Nosebleed
- Respiratory ailments
- Chest pain
- Headache
- Fatigue
- Bloody stools
- Swelling of the abdomen
Even taking Xarelto exactly as your doctor prescribed poses risk factors, but misuse greatly increases adverse reactions.
It is possible to overdose on rivaroxaban, even fatally, because there’s no antidote. Excessive bleeding is the riskiest of adverse rivaroxaban reactions. (10)
Can You Spot the Signs of Xarelto/Rivaroxaban Misuse or Addiction?
Using this medication poses several side effect risks, such as those mentioned above. The internal bleeding side effect has several warning signs that should be viewed as an immediate need for an emergency room visit: (11)
- Pale skin
- Skin that bruises easily
- Blood in the stool
- Lightheadedness or dizziness
- Lethargy
- Swollen abdomen
Any of the possible side effects mentioned above can occur whether you’ve used the medication as prescribed or not.
Some of the signs of rivaroxaban misuse include: (12)
- Looking for multiple rivaroxaban prescriptions from multiple physicians
- Staying on the medication even after the medical need for it has subsided or is no longer occurring
- Doubling up on doses
- Empty Xarelto bottles in the garbage
- Pills kept in unmarked bottles or in easy-to-access locations
- Moodiness
- Changes in sleeping, eating, and social habits or patterns
- Secretive nature
- Relationship strains
- Financial constraints possibly due to paying for medications on the street
- Potential illegal behavior
- Loss of productivity at work
- Grades dropping at school
- Acting out of character
- Mixing Xarelto with other drugs or with alcohol significantly increases all side effects and risks
Addiction causes a loss of control of their drug usage.
A doctor will diagnose addiction if two or more of the following substance use disorder symptoms are present:
- Using a drug for longer than prescribed or in larger doses
- Physically dependent on the substance
- Withdrawal symptoms of Xarelto use are present, such as heart palpitations, leg weakness, or nausea
- Unable to stop using the medication
- Cravings throughout the day
- Spending time using rivaroxaban, going through withdrawals, then looking for more
- Using the drug even though you know it will cause social or emotional problems
- Continuing use even after you know its physical and psychological dangers
- Unable to fulfill your regular obligations, either at home, school, or work
- Using rivaroxaban in hazardous situations
- Loss of interest in items, activities, or events that once held meaning
Even if you’ve been prescribed rivaroxaban for medical reasons, use can become misuse. Misuse of Xarelto over time can turn into an addiction. Similar to that of other drugs such as ibuprofen or naproxen. Dosage and prescribed medication should be overlooked at all times.
Xarelto Misuse In Older Adults
According to the American Heart Association’s Journal (JAHA), the majority of Xarelto patients are over 65. This demographic is vulnerable to misuse of prescription drugs and falling into addiction — but this is often overlooked in older populations. (13)
As you age, your metabolism slows. When taking any medication or supplement, the substance can remain in your bloodstream for longer periods of time, enhancing its effects and resulting in greater impact overall.
Also, social isolation is much more common in older populations, as younger family members have grown up and moved away, older family members may have passed on, and overall living situations simply change.
According to NCADD, around 2.5 million seniors cope with addiction. Drug use and addiction are typically either misdiagnosed in older adults or missed entirely — by doctors and family members. (13)
Symptoms might mimic a different disorder, and because older adults are prescribed multiple medications, it’s more difficult to spot the signs of misuse. (13)
But taking the time to look a little deeper is important because rivaroxaban misuse could be life-threatening. This isn’t a medication that you can stop taking cold turkey, because withdrawals are just as threatening and potentially fatal.
Rather than stopping Xarelto use suddenly, it’s better to enter a program that offers medically assisted detox. Afterward, substance use addiction treatment is the best way to find long-lasting recovery.
What Is Rivaroxaban?
Also known by its brand name, Xarelto, rivaroxaban is a NOAC or novel oral anticoagulant. It is a prescription blood thinner. The FDA approved Xarelto in 2011 for the treatment of DVT, or deep vein thrombosis, for individuals who’ve had a knee replacement surgery or hip replacement. (3)
Another intended prescription use is for those with nonvalvular atrial fibrillation or pulmonary embolism as a way to reduce stroke risk. (4) Xarelto helps stop blood clotting for people in which clotting could pose a significant risk. (4)
When used as intended and under strict medical advice, rivaroxaban is beneficial. However, these types of medication are often misused in a manner not called for on the label. As a blood thinner, rivaroxaban carries a significant risk of excessive bleeding. It can increase the risk of internal brain and gastrointestinal bleeding and increase the potential of permanent spinal paralysis. (3)
The most dangerous aspect of rivaroxaban is that no antidote can reverse these effects once they’ve occurred. Internal bleeding causes lasting damage and can even result in death. (4)
Why is Rivaroxaban Prescribed?
Rivaroxaban is a medication belonging to the class of direct oral anticoagulants (DOACs), and it is primarily prescribed for its anticoagulant or blood-thinning effects. (3) (4)
Here are detailed reasons why Rivaroxaban is prescribed for various medical conditions:
- Prevention of Deep Vein Thrombosis (DVT):
- After major orthopedic surgeries like hip or knee replacement, individuals are at an increased risk of developing DVT. Rivaroxaban is prescribed as a prophylactic measure to prevent the formation of blood clots in the deep veins of the legs, which can be a serious post-surgical complication. (5)
- Treatment of Pulmonary Embolism (PE):
- Rivaroxaban is utilized in the treatment of pulmonary embolism, a condition where blood clots from other parts of the body travel to the lungs. By preventing further clot formation, Rivaroxaban helps manage and resolve pulmonary embolism. (6)
- Reducing Stroke Risk in Atrial Fibrillation:
- Atrial fibrillation is a heart rhythm disorder that increases the risk of stroke due to blood clot formation in the heart. Rivaroxaban is prescribed to individuals with atrial fibrillation to lower the risk of stroke by inhibiting clot formation. (7)
- Preventing Recurrent Venous Thromboembolism (VTE):
- After experiencing an episode of venous thromboembolism (VTE), which includes DVT or PE, individuals may be prescribed Rivaroxaban for an extended period to prevent the recurrence of blood clots. (8)
- Post-Operative Clot Prevention:
- Following certain surgeries, particularly orthopedic procedures like joint replacement, there is an increased risk of blood clot formation. Rivaroxaban is administered postoperatively to prevent clot formation during the recovery period.
- Treatment of Coronary Artery Disease:
- Rivaroxaban may be part of the treatment plan for individuals with coronary artery disease to reduce the risk of cardiovascular events. It helps manage blood clot-related complications in the context of this vascular condition.
- Peripheral Artery Disease (PAD) Management:
- Rivaroxaban can be employed in the management of peripheral artery disease (PAD), a condition characterized by reduced blood flow to the limbs. By preventing clot-related complications, it contributes to the overall care of individuals with PAD. (9)
Understanding the specific conditions and mechanisms for which Rivaroxaban is prescribed emphasizes the importance of tailored medical approaches and patient adherence to prescribed regimens. Regular communication with healthcare providers ensures the safe and effective use of this anticoagulant medication.
How Should This Medicine Be Used?
Rivaroxaban, a blood-thinning medication, is typically administered orally, either with or without food, as directed by healthcare professionals. The recommended dosage is contingent on the specific medical condition being treated, such as the prevention of blood clots after surgery or the management of conditions like atrial fibrillation or deep vein thrombosis.
It is important for individuals to adhere strictly to the prescribed dosage and schedule, taking the medication at the same time each day to maintain a consistent level in the bloodstream. Missing a dose should be avoided, but if it occurs, the missed dose should be taken as soon as remembered unless it’s close to the next scheduled dose.
Regular check-ups with healthcare providers are essential to monitor the effectiveness of the treatment and adjust the dosage if necessary. Any concerns of serious side effects should be promptly communicated to healthcare professionals to ensure the safe and effective use of Rivaroxaban in managing the individual’s specific health condition.
Who Should Not Use This Medication?
Xarelto is an anticoagulant prescribed to prevent blood clots, but certain individuals should avoid taking it due to potential risks. Those with a history of allergic reactions to rivaroxaban or similar medications should steer clear of Xarelto.
Individuals with active bleeding or a high risk of uncontrollable bleeding, such as those with certain medical conditions or undergoing surgery, should not take Xarelto. Pregnant individuals who wish to take an epidural or those breastfeeding may need alternative options, as the effects of Xarelto on unborn babies or nursing infants are not well-established. (14)
Additionally, individuals with catheters or hematomas should consult with healthcare professionals to assess the suitability and safety of taking Xarelto in their specific situations. As a disclaimer, it’s important to consult with a healthcare professional to assess individual health conditions and determine whether Xarelto is a suitable and safe option.
Will Rivaroxaban Interact with Other Medications?
It’s essential for individuals using Rivaroxaban to be aware of potential interactions with other medications, as these interactions can affect the drug’s effectiveness or lead to adverse effects. Rivaroxaban may interact with certain anticoagulants, antiplatelet drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs), increasing the risk of bleeding complications. (15)
Additionally, medications that affect liver enzymes, such as some antifungal drugs and certain HIV medications, can influence Rivaroxaban’s metabolism in the body. To ensure safe usage, individuals should provide a comprehensive list of all medications, including over-the-counter drugs and supplements, to their healthcare provider, who can then assess potential interactions and adjust the treatment plan accordingly.
Open communication with healthcare professionals is key to maintaining the efficacy and safety of Rivaroxaban in addressing specific health concerns.
Signs Of Rivaroxaban and Drug Interactions
Rivaroxaban is an anticoagulant, commonly prescribed to prevent blood clots in conditions like atrial fibrillation and deep vein thrombosis. It’s crucial to be aware of potential reactions when combining rivaroxaban with other medications, as interactions can impact its effectiveness or lead to adverse effects.
Recognizing signs of rivaroxaban reactions to other medications is essential for ensuring the safe and effective management of medical conditions. (16)
- Unusual Bleeding or Bruising: Increased susceptibility to bleeding, a common side effect of anticoagulants. Pay attention to excessive bleeding from minor cuts, prolonged bleeding after injuries, or unexplained bruising. (16)
- Changes in Urine Color: Potential impact on kidney function. Monitor for unusual changes in urine color, especially dark or bloody urine, which may indicate a reaction. (16)
- Gastrointestinal Distress: Digestive system reactions. Watch for symptoms like nausea, vomiting, abdominal pain, or black, tarry stools, suggesting possible gastrointestinal reactions. (16)
- Swelling or Edema: Fluid retention or allergic reactions. Note any sudden or unusual swelling, particularly in the extremities or face.
- Unexpected Changes in Heart Rate: Potential interactions affecting cardiovascular function. Be vigilant for irregular or rapid heartbeat, heart attack, heart valve issues, palpitations, or any unusual changes in heart rhythm. (16)
- Liver Function Abnormalities: Indicative of possible liver-related reactions. Regular monitoring of liver function through blood tests can help identify any adverse effects on the liver. (16)
- Dizziness or Fainting Spells: Cardiovascular or central nervous system reactions. Take note of persistent dizziness, lightheadedness, or instances of fainting.
- Allergic Reactions: Potentially severe immune responses. Be aware of signs such as rash, itching, swelling, severe dizziness, or difficulty breathing, indicating an allergic reaction
Treatment for Rivaroxaban Addiction
If Xarelto needs to be stopped, it should be done under the care of a physician or Xarelto treatment center. When stopping rivaroxaban, it’s necessary to begin taking a different anticoagulant. Treatment for rivaroxaban misuse involves detoxing the body of this medication as you slowly wean yourself into a controlled atmosphere. Your specific treatment schedule may include tapering off dosage as you’re monitored by a treatment professional.
Medically detoxing offers additional medication that can help you mitigate negative reactions or withdrawals. This way your body has time to adjust to no longer receiving the chemicals it had gotten used to. In a professional Xarelto detox program, physicians will constantly monitor your progress, making sure your vital signs remain stable as the drug safely leaves your body.
Once you’ve completed the detox process, the next step is a rivaroxaban addiction treatment program. Some of the benefits of treatment include round-the-clock support, medication education, and best of all — encouragement.
You can take part in support groups filled with others going through similar life changes. You’ll also learn how to modify your behavior in the future and prevent a relapse from happening.
Some of Xarelto’s physical damages aren’t entirely reversible — but you can manage misuse and the addiction’s side effects by detoxing properly and following up with a complete rivaroxaban program in a licensed Xarelto treatment center.
What Are the Withdrawal Symptoms of Rivaroxaban?
Prolonged use of any medication can lead to dependence. Prolonging your use of medications like rivaroxaban can lead to an inability to control its use. This can turn into an addiction.
When you take rivaroxaban for a long time, your brain gets used to how it interacts with your own chemical balance. Stopping suddenly is ill-advised. In fact, one of the most life-threatening situations that can occur from immediately ceasing Xarelto is blood clot-induced stroke. (17)
Additional withdrawal symptoms can include: (17)
- Back pain
- Lightheadedness
- Headaches
- Upset stomach
- Difficulty breathing
- Heart tremors
- Lethargy
- Difficulty falling asleep or waking up
- Potential nerve damage
Think About Treatment Options For Substance Abuse
Considering treatment options for substance abuse is a crucial step toward reclaiming control over one’s life. It involves contemplating various approaches tailored to individual needs and the nature of substance abuse.
Seeking professional guidance is essential to explore interventions such as counseling, therapy, support groups, and potentially medical assistance.
You are not alone. Zinnia Health believes in you, and you deserve the help you desire. We can help you get — and stay — drug-free while learning how to reduce relapse. It’s okay to press the “pause” button on life while you get better, so you can get back to living. Visit our website to find a location near you or call us at (855) 430-9439.
Citations
- https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm
- https://drugabusestatistics.org/
- https://www.ncbi.nlm.nih.gov/books/NBK557502/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5827778/
- https://www.ncbi.nlm.nih.gov/books/NBK534865/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706730/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768287/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055557/
- https://pubmed.ncbi.nlm.nih.gov/32222135/
- https://www.mayoclinic.org/drugs-supplements/rivaroxaban-oral-route/side-effects/drg-20075013
- https://www.healthline.com/health/internal-bleeding
- https://www.nhs.uk/medicines/rivaroxaban/side-effects-of-rivaroxaban/
- https://nida.nih.gov/publications/drugfacts/substance-use-in-older-adults-drugfacts
- https://www.drugwatch.com/xarelto/
- https://www.sciencedirect.com/science/article/abs/pii/S0049384823002888
- https://www.healthline.com/health/drugs/rivaroxaban-oral-tablet
- https://www.medicalnewstoday.com/articles/drugs-xarelto-side-effects
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