Xarelto (Rivaroxaban) 20mg
Product from Canada
No Generic Alternative Available
No generic alternative is available for this drug.
What is a Generic in Canada? Health Canada (the Canadian regulatory board) evaluates every Canadian generic for their safety, effectiveness, and quality. Every generic used in Canada has the same medical ingredients as their brand name counterpart and is considered bioequivalent to the brand name medication. The quality standards for brand name drugs and generic drugs are the same. All of the ingredients, facilities, and manufacturing processes must meet Canadian federal guidelines for Good Manufacturing Practices. In addition, Canadian generic manufacturers must perform 'comparative bioavailability' studies to demonstrate that their generic products deliver the same amount of medicinal ingredient at the same rate as the brand name medication. Nearly 45% of all prescriptions filled in Canada use generic medication and some hospitals exclusively use generic drugs. For more information, please visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php
Xarelto 20mg
Strengths available
Brand name
Xarelto (pronounced as zye-ral-toe)
Generic name
rivaroxaban (pronounced as riv-ah-rocks-ah-ban)
Manufacturer Information
Bayer
About Xarelto 20mg
What is Xarelto used for?
Xarelto, which contains the active ingredient rivaroxaban, is an anticoagulant that is indicated for the prevention of VTE (venous thromboembolic events) in patients after hip or knee replacement surgery, the treatment of VTE, and the prevention of recurrent VTE. Xarelto is also indicated for the prevention of stoke and embolism in patients with AFIB (atrial fibrillation), myocardial infarction, acute limb ischemia, and to decrease mortality in patients with coronary artery disease.
How does Xarelto work?
Xarelto is a new generation anticoagulant that inhibits Factor X. By inhibiting Factor Xa, Xarelto prevents the conversion of prothrombin to thrombin. Xarelto does not affect thrombin directly and therefore does not affect pre-existing thrombin molecules required for homeostatic function. This means that Xarelto can be given at fixed doses that doesn’t require complicated dose adjustments in most populations.
Xarelto Dosing
Depending on the condition being treated, Xarelto dosing can vary from 5mg daily to 20mg daily. Xarelto may be taken with or without food. The exception is if you are crushing your tablets - you can crush Xarelto and mix it with apple sauce immediately before dosing but you need to follow your dose with food. If you’re using Xarelto immediately following surgery, it is recommended that the initial dose be started within 6 to 10 hours. The duration of treatment also depends on your medical condition. Patients using Xarelto following knee replacement surgery may only need the medication for 14 days whereas other patients will continue Xarelto indefinitely.
If you’re using Xarelto once a day and you miss your dose, take it as soon as you remember and then take your next tablet the following day, at your usual time, and carry on with your regular dose schedule. Do not double up on your medication to make up for a forgotten tablet. If you’re prescribed Xarelto 15mg twice a day and you miss a dose, take it as soon as you remember but do not take more than two tablets in one day. Carry on with your usual twice a day schedule after. If you’re using Xarelto 2.5mg twice a day and you forget a dose, take your next 2.5mg tablet at your usual dose time.
Xarelto generic
Even though Xarelto may cost over $500/month in many USA pharmacies, a generic is not expected to be available until 2021 – when the patent of Xarelto will expire.
Xarelto side effects
Most side effects related to Xarelto are related to bruising or bleeding as Xarelto affects your blood clotting system. If you experience bleeding into the eye, from hemorrhoids, under the skin, or increased menstrual bleeding, talk to your doctor if your symptoms are severe. For all other expected bleeding events, talk to your doctor immediately. Other common side effects include nausea, vomiting, constipation/diarrhea, indigestion and decreased energy. Serious side effects unrelated to bleeding include: liver disorders, decreased urine output, fast heartbeat, fever, low blood pressure, and Stevens-Johnson syndrome.
Xarelto and food
When swallowed whole, Xarelto may be taken with or without food. If you are crushing and sprinkling Xarelto, then it is recommended to take Xarelto with food. Grapefruit juice should be avoided in patients using Xarelto as it can increase your exposure to Xarelto. St John’s wort (an over the counter supplement) should also not be used with Xarelto as it can decrease Xarelto’s efficacy.
Can I drink alcohol when taking Xarelto?
There isn’t a direct interaction between Xarelto and alcohol and it is relatively safe to have alcohol while taking Xarelto. However, even moderate amounts of alcohol can act as a blood thinner and, when used with Xarelto, it can increase your risk of bleeding. Most doctor caution patients to avoid alcohol.
Xarelto Drug Interactions
Xarelto is metabolized by CYP3A4 and, as a result, Xarelto has many drug interactions with many commonly used medication.
Avoid using Xarelto with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, and posaconazole – these medication can increase plasma concentrations of Xarelto by 2.6 times (on average) which increases bleeding risk.
Moderate CYP3A4 inhibitors, such as erythromycin or fluconazole can increase Xarelto plasma concentrations by 1.3 to 1.4 times. However, there has been no documentation on clinically relevant effects of this increase in patients with normal renal function. Patients with poor renal function sees plasma concentrations increased by 1.8 to 2.0 times when used with even moderate
CYP3A4 inhibitors and caution is advised.
Strong CYP3A4 inducers, such as phenytoin, phenobarbital, carbamazepine, and rifampicin, should be avoided.
Ordering Xarelto from a Canadian Pharmacy
Depending on where you live in the USA, purchasing Xarelto from your local pharmacy can cost nearly $20/tablet, making it incredibly unaffordable for a long-term and often chronic medication. We all know how crucial this medication is and how many people rely on this medication to prevent life threatening complications. Nowadays, even families with insurance, patient assistance programs, and coupons are increasingly looking for another source of life saving medication – that source is Canada.
Canada is USA’s closest neighbour and the preferred source of safe and effective medication. Canada Cloud Pharmacy is unlike other “pharmacy” websites – Canada Cloud Pharmacy is a real brick-and-mortar pharmacy that serves its local patients and international patients by deliver your Xarelto prescription to your home. Canada Cloud Pharmacy also offers in-store pick up options for all your medication if you find yourself in Vancouver for the weekend. Ordering online is easy! Choose your shipping option and wait for your medication to show up at your door. Speak with a pharmacist now to learn how you can save with Canadian drug prices.
FAQs
Xarelto and Eliquis are different anticoagulants: Xarelto contains the active ingredient rivaroxaban and Eliquis contains the active ingredient apixaban. Both of these medication are used to reduce clotting and embolism in patients with nonvalvular atrial fibrillation. Xarelto has additional indications which allow it to be used for patients undergoing hip or knee replacement surgery. Both medication cause similar side effects and both do not have a generic available. There’s currently no head-to-head studies available between these two medication to compare the differences. Some observational studies conclude that Eliquis may have a lower bleeding risk than Xarelto but the evidence to support this conclusion is weak.
Plavix (clopidogrel) is classified as an anti-platelet medication whereas Xarelto (rivaroxaban) is classified as an anticoagulant. The reason for the difference in classification is that the two medication work differently in the body. Plavix binds to the P2Y12 receptor on platelets and prevents platelet activation to prevent a “blood thinning” effect. Xarelto inhibits factor Xa, a crucial component in the clotting cascade, and directly decreases of the ability of your blood to clot.
Warfarin is a traditional anticoagulant that blocks an enzyme (vitamin K epoxide reductase) to decrease your body’s ability to clot. When compared to traditional anticoagulants (warfarin and heparin), Xarelto safer and more convenient. Routine coagulation monitoring is not usually required because Xarelto has predictable pharmacokinetic and pharmacodynamic profiles; whereas warfarin patients usually need blood work to be drawn at least once a month to monitor their INR. Xarelto also has less dietary restrictions than warfarin. Some patients and doctor may still prefer warfarin as its effects can be easily reversed. Nowadays, in an emergency, there are various assays available to determine the amount of medication in your body and the degree to which coagulation is inhibited by Xarelto and its effects can be reversed as well.
Bayer Pharmaceuticals, the developers of Xarelto, and Johnson & Johnson, the marketers of Xarelto, were involved in numerous lawsuits due to their failure to warn consumers of serious health risks associated with Xarelto use such as uncontrollable bleeding. In 2018, a federal judge selected 1200 cases to go to trial and in March 2019, a $775 million dollar settlement deal was reached to settle 25,000 lawsuits involving Xarelto and its internal bleeding risks.
Xarelto Starter Packs are designed to help patients manage their initial therapy after a pulmonary embolism or deep vein thrombosis, when they are most at risk of another PE or DVT event. A Xarelto Starter Pack contains 30 days' supply of medication – the first 21 days' supply contains Xarelto 15mg twice daily, and the remainder of the pack contains Xarelto 20mg once daily. It is crucial that patients start their anticoagulation therapy exactly when prescribed by the doctor. For USA patients, we usually recommend patients to obtain their Xarelto 15mg from their local pharmacy to start therapy, and then obtain Xarelto 20mg from Canada for an affordable source of their chronic medication.
Buy Xarelto 20mg from Canada
Information contained here on this page is for informational purpose only. Always speak with your Doctor about the usage of your medication.