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Rivaroxaban – pharmacological profile


Authors: K. Urbánek
Authors‘ workplace: Ústav farmakologie, LF UP a FN Olomouc
Published in: Kardiol Rev Int Med 2017, 19(1): 39-44

Overview

Rivaroxaban is an oral selective, direct factor Xa inhibitor. It has well predictable pharmacodynamics and pharmacokinetics. Depending on the size of the dose, it inhibits thrombin formation after 24 hours. It does not block the existing thrombin activity and thus enables continued activation of endogenous anticoagulant factors. After oral administration it is well absorbed, its bioavailability varies between 80 and 100%. It is bound to plasma proteins in 92 to 95%, its average distribution volume is 50 litres. The main metabolising systems are cytochromes P450 3A4 and 2J2. It is excreted mainly via the kidneys; about one third of the administered amount being excreted unchanged, primarily by tubular secretion. The remaining two thirds are excreted as inactive metabolites in urine and bile. The median terminal half-life in younger individuals is 5–9 hours, and 11–13 hours in older individuals. Rivaroxaban pharmacokinetics is minimally affected by age or sex of the patient, and does not require dose adjustments in patients with extremely low or high or with mild-to-moderate renal or hepatic insufficiency.

Keywords:
rivaroxaban – anticoagulants – pharmacodynamics – pharmacokinetics


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