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Dr. Andrew Rynne

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Can internal bleeding be stopped with Xarelto?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15705 Questions

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Posted on Sat, 30 Aug 2014 in Veins and Arteries
Question: Have DVT, yesterday DR replaced warfarin with xarelto. Plus will have chemical clot reduction in two days by radiologist interventionist (vascular degree)
Can internal bleeding be stopped with Xarelto?
Will any of these drugs cause reactions-metformin, Paxil, Trilipix, Niaspan, spironolactone, atorvastatin, metoprolol ?
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Answered by Dr. Michelle Gibson James 58 minutes later
Brief Answer:
metoprolol not supposed to be used with paxil

Detailed Answer:
HI, thanks for using healthcare magic

Warfarin has specific agents that can be used to stop or reduce bleeding. While the newer anti coagulants such as xarelto do not have specific agents, bleeding can both be prevented and treated.

Prevented by using for the time frame needed and avoiding in high risk such as kidney disease (because eliminated somewhat by the kidneys so would build up in system if kidneys not working).

Treated by: (1) withdrawal of the medication- it will then be eliminated from system
(2)compression of site of bleeding if the area is accessible
(3)using fluid replacement to keep up the volume of blood
(4)transfusion of blood products if this is an option
(5)there are also clotting medications that even though not specific to these new medications, can be used to help reduce bleeding

In terms of interactions, none of the medications mentioned interact with xarelto but they are a few other serious interactions between the list.

It is actually advised that metoprolol is never used with paxil due to extensive reaction and risk of serious effects. Paxil affects the level of metoprolol.
There are other members of the SSRI family and other antidepressants that are safer with metoprolol.

There is also risks associated with the atorvastatin with niaspan and trilipix. It is possible , if your cholesterol is extremely high and there is little other option , then the combination would need to continue because the benefits outweigh the risks.
Niaspan and atorvastatin- increase toxicity of each other, same of trilipix and atovastatin.


I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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