利伐沙班的不良反应

Rivaroxaban is used to prevent venous thrombosis (VTE) in adult patients undergoing elective hip or knee replacement surgery. The recommended dose is oral rivaroxaban 10 mg once daily.

If the wound has stopped bleeding, the first medication should be administered between 6 and 10 hours after surgery. The length of treatment is determined by each patient's risk of VTE, i.e. by the type of orthopedic surgery the patient has undergone.

So, what are the adverse effects of taking rivaroxaban?

1. Bleeding risk: Some subgroups of patients have a higher risk of bleeding. After initiation of treatment, these patients should be monitored closely for signs of bleeding complications. This can be accomplished by regular physical examination of the patient, close observation of surgical wound drainage, and regular determination of hemoglobin. Any unexplained decrease in hemoglobin or blood pressure should prompt a search for the site of bleeding.

2. Renal damage: In patients with severe renal impairment (creatinine clearance <30 mL/min), the plasma concentration of rivaroxaban may be significantly increased, leading to an increased risk of bleeding. Rivaroxaban is not recommended for patients with creatinine clearance <15 mL/min. Rivaroxaban should be used with caution in patients with creatinine clearance 15-29 mL/min. Rivaroxaban should be used with caution in patients with moderate renal impairment (creatinine clearance 30-49 mL/min) when used concomitantly with other drugs that may increase rivaroxaban plasma concentrations.

3. Liver damage: In cirrhotic patients with moderate liver damage (Child Pugh category B), the plasma concentration of rivaroxaban may be significantly increased, leading to an increased risk of bleeding. Rivaroxaban is contraindicated in patients with liver disease associated with coagulation abnormalities and clinically relevant risk of bleeding. Rivaroxaban can be used with caution in patients with cirrhosis who have moderate hepatic impairment (Child Pugh category B) and are not accompanied by coagulation abnormalities.

4. Interactions between rivaroxaban and other drugs: azole-antifungal agents (such as ketoconazole, itraconazole, voriconazole and posaconazole).