Rivaroxaban

Pediatric Medication
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This information from Lexicomp® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Xarelto; Xarelto Starter Pack

Brand Names: Canada

AG-Rivaroxaban; APO-Rivaroxaban; JAMP-Rivaroxaban; PMS-Rivaroxaban; PRO-Rivaroxaban; REDDY-Rivaroxaban; RIVA-Rivaroxaban; SANDOZ Rivaroxaban; TARO-Rivaroxaban; TEVA Rivaroxaban; Xarelto

Warning
  • Do not stop giving this drug without talking to your child’s doctor. Stopping this drug before your child is supposed to may raise the chance of blood clots. If your child needs to stop this drug, the doctor will tell you how.
  • People who have any type of spinal or epidural procedure are more likely to have bleeding problems around the spine when already on this drug. This bleeding rarely happens, but can lead to not being able to move body (paralysis) long-term or paralysis that will not go away. The risk is raised in people who have problems with their spine, a certain type of epidural catheter, or have had spinal surgery. The risk is also raised in people who take any other drugs that may affect blood clotting, like blood-thinner drugs (like warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
  • Tell the doctor your child uses this drug before your child has a spinal or epidural procedure. Call the doctor right away if your child has any signs of nerve problems like back pain, numbness or tingling, muscle weakness, paralysis, or loss of bladder or bowel control.
  • Talk with the doctor if your child has recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of this drug and your child’s procedure. Talk with your child’s doctor.

What is this drug used for?

  • It is used to treat or prevent blood clots.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

  • If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
  • If your child has bleeding problems.
  • If your child has any of these health problems: Kidney disease or liver disease.
  • If your child has had or will be having a heart valve replaced.
  • If your child has antiphospholipid syndrome (APS).
  • If your child takes any drugs (prescription or OTC, natural products, vitamins) that must not be taken with this drug, like certain drugs that are used for HIV, infections, seizures, and others. There are many drugs that must not be taken with this drug.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe to give this drug with all of your child’s other drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists. This drug may need to be stopped before certain types of surgery as the doctor has told you. If this drug is stopped, the doctor will tell you when to start giving this drug again after your child’s surgery or procedure.
  • Your child may bleed more easily. Make sure your child is careful and avoids injury. Be sure your child has a soft toothbrush. Rarely, some bleeding problems have been deadly.
  • If your child falls, gets hurt, or hits their head, call the doctor right away. Talk with the doctor even if your child feels fine.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • If your child’s weight changes, talk with the doctor. The dose of this drug may need to be changed.
  • If the patient is a child, use this drug with care. The risk of some side effects may be higher in children.

If your child is pregnant or breast-feeding a baby:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks to your child and the baby.

Granules for oral suspension:

  • This drug has sodium benzoate in it. Sodium benzoate may lead to yellow skin or eyes in newborns up to 4 weeks of age.
  • If your child is on a low-sodium or sodium-free diet, talk with the doctor. Some of these products have sodium.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Dizziness or passing out.
  • Very bad headache.
  • Pain, swelling, or new drainage at wound sites.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

  • Pain in arms or legs.
  • Feeling tired or weak.
  • Cough.
  • Throwing up.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All products:

  • Talk with your child’s doctor or pharmacist about how to give this drug with regard to food.
  • Keep giving this drug to your child as you have been told by your child’s doctor or other health care provider, even if your child feels well.
  • If your child throws up or spits up the dose within 30 minutes of giving this drug, give 1 more dose. If your child throws up or spits up the dose more than 30 minutes after giving this drug, give the next dose at your child’s normal time. If this keeps happening, call the doctor right away.

Tablets:

  • Have your child swallow whole. Do not let your child chew, break, or crush.
  • If your child has trouble swallowing, talk with the doctor.

Granules for oral suspension:

  • Shake well before use.
  • Only use the measuring device that comes with this drug.
  • Put this drug right into the mouth using the measuring device.
  • Rinse the measuring device with water after each use.
  • Those who have feeding tubes may use this drug. Use as you have been told. Flush the feeding tube after this drug is given.

What do I do if my child misses a dose?

One time daily dosing:

  • Give a missed dose as soon as you think about it on the same day your child missed the dose.
  • If you do not think about the missed dose until the day of your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses on the same day.

Two times daily dosing:

  • A missed morning dose can be given with the evening dose unless the doctor has told you otherwise. A missed evening dose can only be given later that same evening. If your child misses an evening dose and you do not remember until the next day, skip the missed dose and go back to your child’s normal time.

Three times daily dosing:

  • Skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

Tablets:

  • Store at room temperature in a dry place. Do not store in a bathroom.

Granules for oral suspension:

  • Store at room temperature. Do not freeze.
  • Be sure you know how long you can store this drug before you need to throw it away. Check the storage information that comes with this drug. If you have questions, check with your pharmacist.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • This drug comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time this drug is refilled. If you have any questions about this drug, please talk with the doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2022-01-07

Copyright

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Last Updated

Monday, December 12, 2022