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Rivaroxaban is a drug used to inhibit blood clotting. The mechanism of action of rivaroxaban is that it directly and highly selectively inhibits factor Xa, independently of antithrombin.  The substance is orally bioavailable. For this reason, rivaroxaban belongs to the direct oral anticoagulants (DOACs). Rivaroxaban does not inhibit thrombin and no influence on the platelets has been demonstrated.

The following applications are indicated: Prophylaxis of stroke and systemic embolism in adult pa-tients with non-valvular atrial fibrillation and one or more risk factors, such as congestive heart failure, hypertension, age above 75 years, diabetes mellitus, stroke or transient ischemic attack; Treatment of deep vein thrombosis and pulmonary embolism as well as prophylaxis of recurrent deep vein thrombosis and pulmonary embolism.

• Routine monitoring is not necessary.
• For complications and risk groups, an anti-factor Xa activity assay is recommended, which should be calibrated and controlled with rivaroxaban.

1. Mani H, Rohde G, Stratmann G, Hesse C, Herth N, Schwers S, Perzborn E, Lindhoff-Last E. Accurate determination of rivaroxaban levels requires different calibrator sets but not addition of antithrombin. Thromb Haemost. 108(1):191-8, 2012
2. Derogis P,  de Aranda L et al. Determination of rivaroxaban in patient’s plasma samples by anti-Xa chromogenic test associated to High Performance Liquid Chromatography tandem Mass Spectrometry (HPLC-MS/MS). PLoS One. 12(2), 2012.