利伐沙班能不能随便停药

(Rivaroxaban) competitively inhibits purified human blood factor xa, with higher selectivity than other biologically relevant serine proteases, and can also simplify and improve the treatment of patients with thromboembolic diseases who require anticoagulant therapy. Currently, in many countries, the drug has been approved for the treatment of diseases such as the prevention of venous thrombosis (DVT), pulmonary embolism (PE), and the prevention of recurrent venous embolism (RVE) after elective hip or knee replacement. So, can patients stop taking rivaroxaban at will?

After patients start treatment with rivaroxaban, they usually cannot stop the drug at will, unless the disease progresses or the drug is intolerable.

Rivaroxaban can be rapidly absorbed in healthy people, reaching peak concentration (Cmax) in 2-4 hours after a single dose of 1.25-80 mg or multiple doses. At doses below 10 mg, the pharmacokinetic parameters are proportional to the dose, and its oral bioavailability reaches 80% to 100%. Studies have shown that after a single oral dose of rivaroxaban, the absolute bioavailability of rivaroxaban is reduced by 66% under fasting conditions; when taken with food, the area under the curve (AUC) increases by 39% and Cmax increases by 76%, so rivaroxaban should be taken with food.

Direct oral anticoagulants (Xarelto) are currently available for the treatment of a variety of thromboembolic diseases and provide alternative strategies for anticoagulation therapy and patient management. Due to its predictable pharmacokinetic and pharmacodynamic characteristics and fewer drug interactions, compared with traditional anticoagulants, it is more effective, does not require constant monitoring, has good safety and is easy to use. However, the combined use of strong inhibitors of cYP3A4 and P-gp has not been recommended. It must be emphasized that specific patient groups, such as the elderly and patients with renal impairment, should be aware of dosage adjustments.

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