Rivaroxaban ( Xarelto) -Dosage

[jeffsimon]

I am a 73 year old male with well managed AF and a current CHADS score of 1 which presumably will rise to 2 when I reach 75. I have been taking Rivaroxaban 20 mg for some 6 months with no side effects except for some Haematospermia. In an effort to try to rid myself of this disconcerting side effect I would like to lower my daily dosage of Rivaroxaban. Can anyone advise me if my chances of stroke will increase substantially if I lower my daily dosage of Rivaroxaban to 15 mg?

[BobD Volunteer]

Sorry but we shouldn't give advice such as that here. Please discuss with your health care provider. All I will say is that CHADSVASC is a generalisation and not a literal guide. It is , however, all we have at present. Nobody can really explain how a day in your life i e your 75th birthday suddenly makes you more likely to have a stroke and we do have members who albeit much younger than you were advised that they did not need anticoagulation who subsequently had strokes or TIAs.

There is also ample evidence that the amount or severity of AF has no bearing on stroke risk so being "well managed" doesn't really affect the risk.

Please do discuss with your doctor.

Bob

[jeffsimon in reply to BobD]

Many thanks for your prompt reply Bob but my question was about dosage and not really about CHADS in particular and whether reducing to 15mg would significantly increase the chance of a stroke.

[AnticoagulateNow]

Don't do it!

With many drugs, their effectiveness is proportional to their dosage up to a point. But with others and I would imagine this includes Rivaroxaban, they are finely balanced in their composition and dosage critical.

It could be extremely dangerous to experiment with prescribed dosages unless you have the total support of a senior medical professional. I know apixaban is served in a half-dose to certain individuals but......don't mess with NOACs unless you really know what you are doing - which at the moment.....you don't!

[jeffsimon in reply to AnticoagulateNow]

Thanks again Bob for your advice.

[AnticoagulateNow in reply to jeffsimon]

My pleasure....