A medication used to prevent and treat blood clots by selectively inhibiting factor Xa, thereby reducing thrombin generation and indirectly decreasing thrombin-induced platelet aggregation.

Indications:
- Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
- Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).
- Prevention of recurrence of DVT and PE.

Main Active Ingredient:
- Rivaroxaban 15 mg.

Precautions:
- Use with caution in patients with an increased risk of bleeding.
- Inform your doctor if you have kidney disease, liver impairment, or a history of bleeding disorders.
- Consult a physician before use during pregnancy or breastfeeding.
- Avoid use with other anticoagulants unless specifically prescribed.
- Keep out of reach of children.
- Store below 25 °C in the original container.
- Protect from moisture.
- Keep out of sight and reach of children.
- Do not use after the expiry date.

Side Effects:
- Bleeding from various sites (gastrointestinal, genitourinary, nosebleeds, gums, eyes, or surgical wounds).
- Decrease in red blood cells leading to pallor, weakness, or shortness of breath.
- Bruising, hematoma, or swelling of extremities.
- Impaired kidney function.
- Gastrointestinal discomfort (nausea, vomiting, constipation, diarrhea, stomach pain).
- Low blood pressure, headache, dizziness, or fainting.
- Skin rash or itching.
- Elevated liver enzymes.

Drug–Drug Interactions:
- Caution with warfarin, aspirin, clopidogrel, and ibuprofen due to increased risk of bleeding.
- Avoid ketoconazole and ritonavir as they may increase blood levels of rivaroxaban and raise bleeding risk.
- Avoid rifampin, phenytoin, carbamazepine, and St. John’s Wort as they may reduce the effectiveness of Xarelto.
- Use caution with erythromycin, clarithromycin, and itraconazole, as they can affect drug levels.
- Inform your doctor about all prescription and over-the-counter medicines, herbal supplements, or vitamins before using Xarelto.