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Switching from xarelto to warfarin. Is it normal?

May 2014
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Practicing since : 2002
Answered : 6504 Questions
Switching from 20 mg xarelto to warfarin
Posted Sat, 3 Aug 2013 in Medicines and Side Effects
Answered by Dr. Vivek Chail 2 hours later
Hi Tarekaliha,
Thanks for writing in.

I suppose you are a 75 years old gentleman with a history of chronic atrial fibrillation and a lased prostatectomy done recently. Your main concern is switching over from Xarelto (rivaroxban) to warfarin.

Your question is a very important one. Xarelto (rivaroxaban) is an oral anticoagulant which acts by altering the INR (international normalized ratio) of blood. While switching over from Xarelto to warfarin, one approach is to stop Xarelto and then start parenteral anticoagulant and warfarin at the time of next scheduled dose. Also no clinical trial data are available to guide converting patients from Xarelto to warfarin.

I would like to mention that there is a research study on patients having chronic arrhythymia who switched over from Xarelto to warfarin. This study shows that there is a very small increased risk of stroke in atrial fibrillation patients after switch from Xarelto to warfarin.

I suppose your doctor is aware of this fact and is taking a decision where the benefits are greater than the risks involved.

Hope your query is answered.
Further questions welcome.

Wishing you good health.

Dr Vivek
Above answer was peer-reviewed by
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