Xarelto is the brand name for rivaroxaban, a prescription anticoagulant commonly called a blood thinner. It belongs to a group of medicines known as direct factor Xa inhibitors. Xarelto is prescribed to prevent or treat certain blood clots and may be used for conditions such as atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism (PE), and certain heart or blood vessel conditions.
Because Xarelto helps prevent blood clots, taking it consistently is important. Missing a dose can reduce the amount of medication available to prevent clot formation. The possible consequences depend on why you take Xarelto, your prescribed dose, how long the dose is missed, and your individual risk factors.
If you accidentally miss a dose, do not panic. The appropriate response depends on your dosing schedule. It is also important not to stop Xarelto on your own because stopping rivaroxaban can increase the risk of blood clots.
Key Takeaways
- Xarelto is a prescription anticoagulant, or blood thinner, that contains rivaroxaban.
- It works by blocking factor Xa, which plays an important role in blood clotting.
- Xarelto may be prescribed to prevent or treat conditions involving blood clots.
- Missing doses or stopping Xarelto without medical advice can reduce protection against blood clots.
- Because Xarelto reduces clotting, unusual or serious bleeding should be reported to a healthcare professional.
What Is Xarelto?
Xarelto is a prescription blood thinner that contains the active ingredient rivaroxaban. It belongs to a group of medicines called anticoagulants, which help prevent harmful blood clots from forming.
Doctors may prescribe Xarelto to prevent strokes in people with certain heart conditions, treat deep vein thrombosis (DVT), or treat and prevent pulmonary embolism (PE). It may also be used to prevent blood clots after certain surgeries.
Xarelto works by blocking factor Xa, a protein involved in blood clotting. Because it affects clotting, Xarelto can increase the risk of bleeding. Always take Xarelto exactly as prescribed and talk to your doctor before stopping it.
What Happens If You Miss a Dose of Xarelto?
Xarelto works by blocking factor Xa, a substance involved in the body’s clotting process. When you miss a dose, the medication’s anticoagulant effect may become less consistent.
A single missed dose does not necessarily mean that you will develop a blood clot. However, missing doses repeatedly or stopping treatment without medical guidance can leave you less protected against the clotting problem for which Xarelto was prescribed.
For people taking rivaroxaban to prevent stroke related to atrial fibrillation, stopping treatment can increase the risk of stroke. For people taking it to treat or prevent DVT or PE, interrupted treatment can increase the risk of another clot.
Are There Side Effects From Missing Xarelto?
Missing a dose does not usually cause a specific withdrawal-type side effect.
The main concern is that the medication may not provide its intended protection against blood clots.
Depending on the condition being treated, a person may have an increased risk of complications such as:
- A blood clot in a deep vein
- A pulmonary embolism
- Stroke
- Other clot-related complications
However, these problems do not automatically occur after one missed dose.
Some people may not notice any immediate symptoms after missing a dose. This is why taking Xarelto consistently is important even when you feel healthy.
Can Missing Xarelto Cause a Blood Clot?
Missing Xarelto can potentially increase the risk of a blood clot because there may be less anticoagulant protection.
The risk varies considerably between individuals. Someone taking Xarelto after a recent DVT or PE may have different risks from someone taking it for another reason.
This is why you should not intentionally skip doses or discontinue treatment because you feel well. Medications such as rivaroxaban are often used to prevent problems before they happen.
Can Missing Xarelto Cause a Stroke?
For people taking Xarelto because of atrial fibrillation, missing doses or stopping treatment can increase the risk of stroke.
Atrial fibrillation can allow blood to pool in the heart, which may contribute to clot formation. If a clot travels to the brain, it can cause a stroke. Xarelto helps lower this risk by reducing the body’s ability to form certain clots.
MedlinePlus specifically warns that people taking rivaroxaban for atrial fibrillation have a higher risk of stroke after stopping the medication.
What Should You Do If You Miss a Dose?
The correct action depends on your Xarelto dose and dosing schedule.
For adults taking 2.5 mg twice daily, the prescribing information says that if a dose is missed, a single 2.5 mg dose should be taken at the next scheduled time.
For adults taking 15 mg twice daily for certain DVT or PE treatment, the missed dose should be taken as soon as possible so that the patient receives the prescribed total daily amount. Two 15 mg tablets may be taken together in this specific situation.
For adults taking 10 mg, 15 mg, or 20 mg once daily, the missed dose should be taken as soon as possible on the same day. The dose should not be doubled within the same day to make up for a missed dose.
Because Xarelto is prescribed for different conditions and at different doses, follow the instructions provided with your prescription and speak with your doctor or pharmacist if you are unsure what applies to you.
Should You Take Two Xarelto Pills If You Miss One?
Not necessarily.
You should not automatically take two doses to make up for a missed Xarelto dose.
The correct instructions depend on your prescribed strength, dosing schedule, age, and reason for treatment. For example, certain adults taking 15 mg twice daily for DVT or PE treatment may be instructed to take two 15 mg tablets at once when a dose is missed, while people on several once-daily regimens should not double their dose.
If you are unsure, contact your pharmacist or prescribing healthcare professional rather than guessing.
What Happens If You Miss Multiple Doses?
Missing several doses can be more concerning than missing one dose because you may spend a longer period with less anticoagulant protection.
The consequences depend on why Xarelto was prescribed and your individual risk of clotting.
If you have missed multiple doses, contact your doctor or pharmacist for specific instructions. Do not take several extra doses unless you have been specifically instructed to do so.
If you have completely stopped taking Xarelto, contact your healthcare professional as soon as possible.
Can You Feel Anything After Missing Xarelto?
You may not feel anything after missing a dose.
Blood clots can sometimes develop without obvious symptoms, which means the absence of symptoms does not necessarily mean that missing doses is harmless.
If a clot does occur, symptoms depend on where the clot develops.
A DVT may cause swelling, pain, tenderness, warmth, or changes in the color of a leg or arm. A pulmonary embolism can cause sudden shortness of breath, chest pain, rapid heartbeat, coughing, or coughing up blood.
A stroke may cause sudden weakness or numbness, trouble speaking, confusion, vision problems, dizziness, or difficulty walking.
These symptoms require urgent medical attention.
Warning Signs of a Blood Clot
If you have missed Xarelto and develop symptoms that could indicate a blood clot, seek medical attention promptly.
Possible signs of DVT include:
- Swelling in one leg or arm
- Pain or tenderness
- Warmth in the affected area
- Skin that appears red or discolored
Possible signs of pulmonary embolism include:
- Sudden difficulty breathing
- Chest pain, especially when breathing deeply
- Rapid heartbeat
- Coughing up blood
- Sudden lightheadedness or fainting
A stroke can cause sudden facial drooping, weakness or numbness on one side of the body, difficulty speaking, confusion, vision changes, or trouble walking.
Call emergency services immediately if you experience symptoms that could indicate a stroke or pulmonary embolism.
Should You Stop Xarelto If You Feel Fine?
No. Feeling well does not mean that you no longer need Xarelto.
Rivaroxaban is often prescribed to prevent serious complications from blood clots, so you may not notice any benefit from the medication day to day.
Stopping Xarelto without medical guidance can increase your risk of developing a blood clot. MedlinePlus advises patients not to stop taking rivaroxaban without speaking with their doctor.
If you are experiencing side effects or are concerned about taking Xarelto, speak with your healthcare professional rather than stopping it yourself.
What If You Forgot Whether You Took Xarelto?
If you cannot remember whether you already took your dose, do not automatically take another tablet.
Taking an additional dose when you already took the prescribed dose could increase your exposure to the medication and potentially increase bleeding risk.
Check your medication organizer, medication app, written record, or other reliable reminder if available. If you still cannot determine whether you took the medication, ask your pharmacist or healthcare professional what to do.
How Can You Prevent Missing Xarelto?
Taking Xarelto at the same time each day can make it easier to remember.
Helpful strategies include:
- Set a daily phone alarm.
- Use a medication reminder app.
- Keep a written medication schedule.
- Use a pill organizer when appropriate.
- Connect the dose with a consistent daily routine.
- Make sure you have enough medication before your prescription runs out.
MedlinePlus also recommends using reminders, medication charts, and consistent daily routines to help prevent missed doses.
What If You Keep Forgetting Your Doses?
If you frequently forget Xarelto, tell your doctor or pharmacist.
They may be able to help you establish a medication routine or identify practical ways to make your schedule easier to follow.
Do not change the dose or dosing frequency yourself.
If remembering your medication is difficult, a healthcare professional can also explain what to do when a dose is missed and help you create a plan for future situations.
Can You Take Other Medicines After Missing Xarelto?
Be careful about taking other medications to compensate for a missed Xarelto dose.
Do not take an extra anticoagulant or blood thinner unless your healthcare professional specifically tells you to do so.
Also tell your doctor or pharmacist about other medicines you take. Certain medications can interact with rivaroxaban or increase the risk of bleeding. MedlinePlus specifically advises patients to discuss prescription medicines, over-the-counter drugs, vitamins, and supplements with their healthcare professional.
When Should You Contact Your Doctor?
Contact your healthcare professional if you:
- Miss multiple doses.
- Are unsure how to handle a missed dose.
- Accidentally take an extra dose.
- Want to stop taking Xarelto.
- Have difficulty remembering your medication.
- Need surgery or a dental procedure.
- Develop unusual bleeding or bruising.
Your doctor or pharmacist can provide instructions based on your exact Xarelto dose and the condition being treated.
Frequently Asked Questions
How quickly does Xarelto start working?
Xarelto begins affecting the blood-clotting process relatively quickly after it is taken. The exact timing depends on the dose and why it has been prescribed.
How long does Xarelto stay in your system?
Xarelto is gradually removed from the body, but the timing can vary based on factors such as age, kidney function, and other health conditions.
Can you take Xarelto with food?
Some Xarelto doses should be taken with food, while others can be taken with or without food. Follow the instructions provided for your specific prescription.
Can you drink alcohol while taking Xarelto?
Alcohol can increase the risk of bleeding, particularly with heavy or frequent drinking. Ask your doctor whether alcohol is appropriate for you while taking Xarelto.
Can Xarelto cause easy bruising?
Yes. Easy bruising can occur because Xarelto reduces the blood’s ability to form clots. Contact your healthcare professional if bruising is severe, unexplained, or increasing.
Does Xarelto need regular blood tests?
Unlike warfarin, Xarelto usually does not require routine INR monitoring. Your doctor may still order blood tests to monitor kidney function, liver function, or other health factors.
Can Xarelto cause stomach problems?
Xarelto can cause side effects involving the digestive system in some people. More importantly, bleeding in the stomach or intestines can occur and requires medical attention.
Can you take ibuprofen while taking Xarelto?
Ibuprofen can increase the risk of bleeding when combined with Xarelto. Talk to your doctor or pharmacist before taking ibuprofen or other NSAIDs while using Xarelto.
What should you tell your dentist if you take Xarelto?
Tell your dentist that you take Xarelto before dental treatment. Do not stop taking it on your own, as your dentist and doctor may need to coordinate your care.
Can you stop Xarelto suddenly?
You should not stop Xarelto without medical advice. Stopping treatment can increase the risk of blood clots and related complications, depending on why you take the medication.
Conclusion
The main concern with missing a dose of Xarelto is reduced protection against blood clots, rather than a typical medication side effect. A single missed dose does not mean that a clot will definitely occur, but repeated missed doses or stopping treatment can increase the risk of serious complications.
What you should do after missing a dose depends on your Xarelto strength and dosing schedule. Some people may need to take the missed dose as soon as possible, while others should follow their next scheduled dose. Certain twice-daily regimens have specific instructions that allow a missed dose to be taken later the same day.
If you are unsure what to do after missing Xarelto, contact your pharmacist or prescribing healthcare professional. Do not routinely double doses or stop treatment on your own.
Disclaimer: This article is for informational purposes only and is not a substitute for medical advice. Always consult your doctor or pharmacist about your medication.
