用利伐沙班需要注意什么？

Rivaroxaban is used in adult patients undergoing elective hip or knee replacement surgery to prevent venous thrombosis (VTE). So, what should you pay attention to when using rivaroxaban?

Precautions for Rivaroxaban:

1. Early discontinuation of rivaroxaban will increase the risk of thromboembolism.

Premature discontinuation of any oral anticoagulant, including rivaroxaban, in the absence of adequate alternative anticoagulant therapy will increase the risk of thromboembolic events.

2. Bleeding risk

Rivaroxaban increases the risk of bleeding and may cause serious or fatal bleeding. When deciding whether to use rivaroxaban in patients at higher risk for bleeding, the risk of thromboembolic events must be weighed against the risk of bleeding.

3. Reversal of anticoagulant effect

There is no specific vaccine for rivaroxaban. Rivaroxaban is not observable due to its high binding to plasma proteins. Protamine sulfate and vitamin K are not expected to affect the anticoagulant activity of rivaroxaban.

4. Spinal tap/epidural anesthesia

Patients receiving antithrombotic drugs to prevent thrombotic complications during epidural anesthesia or spinal tap are at risk for developing epidural or spinal hematoma, which may lead to long-lasting paralysis.

5. Used in adult patients with non-valvular atrial fibrillation to reduce the risk of stroke and systemic embolism

Avoid use of rivaroxaban in patients with CrCl <15 mL/min as drug exposure will be increased. Assess renal function periodically as clinically indicated (i.e., more frequently if renal function may be reduced) and adjust treatment accordingly. If acute renal failure occurs while taking rivaroxaban, discontinue rivaroxaban.

6. Patients with acute pulmonary embolism

Rivaroxaban is not recommended for use in these patients.

7. Dosage recommendations before and after invasive procedures and surgical treatments

If invasive procedures or surgical treatments are required, intervention should be performed at least 24 hours after stopping rivaroxaban, if the situation permits and based on the physician's clinical judgment.