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What are the risk factors of stopping Xarelto suddenly?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I just had knee replacement surgery, and the doctor recommended Aspirin. I asked if I could take Xarelto. Now I am at home and have been on 5 mg of Xarelto for three days. I am finding it interferes with everything I take. Can I stop it and go on with Aspirin? Will I have a stroke from suddenly stopping it?
Answered by Dr. Atul Prakash

Education:

MBBS

Professional Bio:

Dr. Atul Prakash is an Orthopedic Surgeon specializing in the diagnosis, treatment, and surgical management of musculoskeletal conditions. His expertise includes joint replacement, fracture management, sports injuries, spine disorders, and arthroscopic procedures. He is committed to providing patient-centered care, advanced treatment planning, and optimal recovery outcomes.

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Hi,

Welcome to icliniq.com.

Aspirin is safe as you are fully mobile. Yes, Xarelto (Rivaroxaban) can be stopped, but any increase in the stroke risk (rebound) phenomenon can be countered by starting Aspirin 150 mg once daily before you stop Xarelto (Rivaroxaban). Xarelto stays in your system for a day. So, a one-day overlap is fine. Finally, Xarelto (Rivaroxaban) was started as an alternative to Aspirin, not to prevent strokes.

Patient's Query

Hi doctor,

Thank you for the reply, As you said, Xeralto can be stopped, but any increase in the stroke risk (rebound) phenomenon can be countered by starting Aspirin 150 mg of it once daily before you stop Xeralto. What does that mean? I could have a stroke after stopping Xeralto. Does that mean even if I was on Xeralto for a month?

Answered by Dr. Atul Prakash

Education:

MBBS

Professional Bio:

Dr. Atul Prakash is an Orthopedic Surgeon specializing in the diagnosis, treatment, and surgical management of musculoskeletal conditions. His expertise includes joint replacement, fracture management, sports injuries, spine disorders, and arthroscopic procedures. He is committed to providing patient-centered care, advanced treatment planning, and optimal recovery outcomes.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Hi,

Welcome back to icliniq.com.

Xarelto (Rivaroxaban) is known to cause an increased risk of stroke when stopped. This statement is true but needs to be qualified that this is seen in studies that was conducted on patients with an irregular heartbeat, which is a risk factor. It is an inference that cannot be correlated with the patient on Xeralto (Rivaroxaban) for knee replacement. Also, when you start Aspirin, stop Xeralto (Rivaroxaban) a day before and that will belt and brace any such possibility.

Thank you.

Medically reviewed by iCliniq medical review team
Published At December 5, 2022
Reviewed At May 17, 2024

Education:

MBBS

Professional Bio:

Dr. Atul Prakash is an Orthopedic Surgeon specializing in the diagnosis, treatment, and surgical management of musculoskeletal conditions. His expertise includes joint replacement, fracture management, sports injuries, spine disorders, and arthroscopic procedures. He is committed to providing patient-centered care, advanced treatment planning, and optimal recovery outcomes.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

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Dr. Atul Prakash

Orthopedician and Traumatology

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Education:

MBBS

Professional Bio:

Dr. Atul Prakash is an Orthopedic Surgeon specializing in the diagnosis, treatment, and surgical management of musculoskeletal conditions. His expertise includes joint replacement, fracture management, sports injuries, spine disorders, and arthroscopic procedures. He is committed to providing patient-centered care, advanced treatment planning, and optimal recovery outcomes.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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