Rivaroxaban to Prevent Pulmonary Embolism After Hip or Knee Replacement

Rivaroxaban (Figure 1) is a new oral prescription medication used to help prevent clots from forming. Rivaroxaban is marketed under the brand name Xarelto, and it is approved in the United States, Canada, and Europe to prevent blood clots in patients undergoing an elective hip or knee replacement and to prevent stroke from atrial fibrillation. This Cardiology Patient Page will discuss the use of rivaroxaban to prevent pulmonary embolism and deep vein thrombosis after hip or knee replacement.Figure 1. Rivaroxaban (Xarelto) 10-mg tablets.Although there are many risk factors for developing a blood clot after surgery, one of the biggest is being immobile after surgery. Patients are at risk for developing a blood clot up to 3 months after surgery. Anticoagulants or “blood thinners” prevent blood clots from forming after surgery. Although these medications do not actually “thin” your blood, they make it more difficult for blood to clot.Proteins, called clotting factors, and platelets, a type of blood cell, are normally found flowing through your blood vessels. When you have a cut or when you are not moving and your blood becomes sluggish, clotting factors and platelets work together to form a clot or thrombus. Although this natural process helps you stop bleeding when you have a cut, it can be harmful when blood clots develop in the arms, legs, or lungs. This process is called the coagulation cascade (Figure 2). One …