Interní Med. 2010; 12(1): 44-46

Rivaroxaban (XARELTO) - an orally administered anticoagulant for thromboprophylaxis in orthopedic surgery

doc.MUDr.Otto Mayer, CSc.

Oddělení klinické farmakologie FN v Plzni

Thromboprophylaxis in orthopedic surgery is recently realized using low molecular heparins applied parenterally followed by warfarin

with the necessity of laboratory monitoring. New orally administered anticoagulants are now available. Substances are of the character

so-called „small molecules” being direct inhibitors of coagulation enzymes. Rivaroxaban is direct inhibitor of factor Xa which represents

a common product of the external and internal branch of coagulation cascade. Its inhibition slows down catalytic processes in whole

cascade reducing thrombin production as following step. There is presented a review of studies of the phase II and III realized in patients

after hip- and knee replacement in comparison with enoxaparin. A fixed orally administered rivaroxaban dose 10 mg (one tablet) once

daily was derived from the results of studies for wide majority of patients. No adjustment has to be made following body weight, age as

well as in case of moderate renal failure. Rivaroxaban was superior to enoxaparin evaluating thromboembolic protection 5 weeks after

hip- and 2 weeks after knee replacement. Bleeding as side effect did correspond to frequency after enoxaparine and was rare at all.

Conclusion: Rivaroxaban represents an innovative anticoagulant bringing a possibility to provide profylactic treatment with a simple

standard 10 mg once daily dose without necessity of laboratory monitoring.

Keywords: anticoagulants, rivaroxaban, thromboprophylaxis, orthopedic surgery

Published: May 1, 2010  Show citation