利伐沙班使用注意事项

(Rivaroxaban), as a substitute for low molecular weight heparin and warfarin, has been used as a clinical first-line anticoagulant in orthopedic surgery and cardiology departments. In recent years, this drug has also received widespread attention in other disciplines, especially in the anticoagulant treatment of malignant tumors combined with deep vein thrombosis. In order to ensure that patients can get the maximum benefit from it, patients need to pay close attention to the following points during medication:

1. Under normal circumstances, the recommended dose of rivaroxaban is 10 mg/time, once/day. The medication is taken orally and can be taken with food.

2. Adverse reactions and countermeasures for bleeding during use of this drug: Instruct patients to be careful not to cut the skin during use, and to avoid falls, collisions, and strenuous exercise that can cause physical harm; brush teeth and shave gently, and use soft-bristled toothbrushes and electric shavers to reduce injuries. If gum bleeding, skin bruising, nose bleeding, hematuria, or wound bleeding occurs during anticoagulant treatment, please consult your doctor or pharmacist.

3. If a missed dose of rivaroxaban (i.e. Xarelto) occurs, patients taking once-daily dose can take it again if it is >12 hours before the next dose; patients taking twice-daily dose can take it again if it is >6 hours before the next dose.

4. Precautions when switching to other anticoagulants: Please ask your doctor for adjustment. When switching from rivaroxaban to warfarin, warfarin and rivaroxaban should be combined until rivaroxaban is discontinued when the INR is ≥2.0, and the INR is continued to be monitored until stable; when switching from rivaroxaban to a non-oral anticoagulant, rivaroxaban should be discontinued, and the first dose of non-oral anticoagulant should be given at the next scheduled dose of rivaroxaban.

5. Principles for discontinuing medication during surgical operations: Please find a doctor for adjustment. For surgeries with a low risk of bleeding, if the patient's CrCl15>30 mL/min, the drug should be stopped for ≥24 hours; if the patient's CrCl15~29 mL/min, the drug should be stopped for ≥36 hours. Surgery with intermediate-risk, high-risk, or uncertain bleeding risks should be discontinued for 48 hours.

6. During the treatment period, patients should regularly monitor blood routine and liver and kidney functions, and also conduct regular follow-up visits.

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