Does anyone know how much food you have to eat when taking a dose of rivaroxaban? I prefer to take the drug in the morning for convenience with a very small breakfast but a biochemist or maybe he's a biomedical scientist thought that blood levels of the anticoagulant are higher and more stable when the drug is taken with a larger meal. Does anyone know about this?
I'm new to this site and fairly new to AF so appreciate advice
I take mine with my evening meal now. I was told that to absorb to full effect the meal has to contain some fats. I used to take it at supper time but find either morning with a decent breakfast or with evening meal works well meal size wise. The problem is you need to take it at the same time of day exactly and we don't always manage to eat at the same time every day as routines change.
Breakfast is probably a good time as long as you have a decent sized breakfast it doesn't have to be huge.
Thanks for that. It 's been helpful as I didn't know about the fats. Appreciate your response.
My understanding is a proper meal which must contain some fat so breakfast is a bad idea unless it is a full English with greasy bacon. fried bread et al. Damn it I'm hungry now!
If you prefer to stick with breakfast time which was the consultant haematologist at my teaching hospitals recommendation, she suggested a good size bowl of cereal with full fat milk and toast with butter was just fine. If you prefer a full English breakfast then the fat content in that was good too. Just be sure there is fat content of note.
Good question. I take mine with breakfast which is generally a protein shake with blueberries, almond & coconut milk and full fat Greek yogurt. I might check with with my pharmacist and see if I should change it to night time (but then I’m worried I’ll forget it and our dinner time varies considerably).
Wow. Nobody told me to take it with food. I take it at bedtime. No ill effects but will change now.
Same here!.
I take mine lunchtime after a sandwich.
After speaking to my own GP.
Was told I was doing it correctly.
Are we all told something different?
Took my rivaroxaban 10pm. With my magnesium and, bisoprolol actually I am a bit worried. My poo is black today. Sign of blood. But I did have 2 mini beetroots. Would that do it.
If you take it without fatty foods, absorption is less, so less chance of bleeding. Is stool sticky, tarry black or just darker than usual. Beetroot does colour urine and stools other foods too change colour.
It's not as easy as it would appear !!! If like me you are watching what you eat in an attempt to get some weight off , fat is one of the foods limited . Lunch and evening meal are eaten at random times , so for me rivaroxaban is best taken at breakfast ......usually with small bowl of cereal , semiskimmed milk , 1/2 banana and blueberries. Not much in the way of fat but the best I can do ! Dammed if we do and dammed if we don't lol !
Jean x
Wow - an amazing variety of answers. I take mine in the morning with my other drugs, as advised by my pharmacist, then eat fruit for breakfast. Doing Slimming World at present.
Yes it is confusing.... I suppose we each have to do what feels workable for us. In some ways reduced absorption would be better than forgetting the dose altogether as I have done before if left till the evening ! Thanks so much for all advice.
It was confirmed when I was in hospital for my ablation last week that yes, it is better to take rivaroxaban with food and in the evening. However, I didn't know it had to be at the same time and that will never happen!
It is all about the absorption - which for each DOAC is different - Pradaxa & Rivaroxaban are digested and absorbed in the stomach - hence the need for protein/fat when taken AND taken with water, with Pradaxa a full glass is recommended, whilst the others are digested lower in the GI tract and not as food dependent for absorption. Personally I don’t think nearly enough research is carried out and accurate information cascaded down from the drug companies - there are studies and published papers - but boy do you have to search for them. Hence the general ignorance by some doctors and many patients.
I had a lot of digestive problems with Pradaxa and had to do my own research and ended up informing the doctors as to my own resolutions how and why I came by them as as all they wanted to do was prescribe PPIs.
Some studies showed that the biovariability of a DOAC could vary through individuals greatly and if not taken correctly the prophylactic efficacy decreased by as much up to 85% in some people. It also seems to me, although I can’t find much literature at all directly about the relationship between drug absorption and GI tract health, especially gut health, which to my simple mind seems a bit obvious??
Seems to be the topic of the month at the moment as I notice several such posts recently.
Hi,
CDreamer,
I had the same journey as you regarding research. Eating low carbs, I fast for 16 hours overnight and I don't feel hungry so breakfast isn't an option, so I've moved taking my 20mg rivaroxaban/Xaltero to lunch time. However, it's not always possible to eat a meal at lunch time in my line of work due to meetings. I couldn't find the trials or research that mention meals / food amounts specified to aid the most effective gut absorption. But have found pharma companies don't always publish all of their research.
I wrote to the medical.information@bayer.co.uk email address and asked them to provide specific information from their trials or research which enabled them to obtain a licence for the drug regarding the amount of 'food' in a 'meal' (which is the words they use in their guidance). The response they provided was patronising in the least. See the response below. It appears to be deliberately vauge, telling me to ask my GP to ask the question on my behalf as if I'm unable to understand basic information.
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Thank you for taking the time to contact Bayer about Xarelto® (rivaroxaban). We understand you have asked what is meant by ‘food’ when taking Xarelto? As you may be aware, the Patient Information Leaflet (PIL) for Xarelto 20 mg states:
3. How to take Xarelto
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure...
...Take Xarelto together with a meal...
Please note, Bayer does not recommend a specific type of meal or calorie intake range to be taken with each dose. Additionally, there are no dietary restrictions while taking rivaroxaban.
Why does Xarelto 20 mg need to be taken with food?
Taking Xarelto 20 mg together with a meal is recommended because, at higher doses,
rivaroxaban’s absorption into the body has been found to be affected by food intake.
2 Studies have shown that for higher doses, the absorption of rivaroxaban is increased in the fed state compared to fasting conditions. If you forget to take Xarelto with food, the
absorption of the medicine and its effect may be reduced. We can therefore only recommend that rivaroxaban is taken as per the instructions in the Patients Information Leaflet i.e. rivaroxaban 15 mg and 20 mg tablets are to be taken with food.
Ultimately, the decision regarding the dietary recommendations for taking rivaroxaban, if
any, would be at the clinical discretion of your treating physician.
If you have any further queries in regards to your treatment with rivaroxaban, we would
recommend that you speak with your physician or other preferred healthcare professional
regarding this matter. With access to your personal medical history and records, they will be best placed to provide you with further advice, support and guidance regarding your
treatment. Should your healthcare professional require additional information on the technical aspects of this product in order to assist with your queries, they are welcome to contact us directly by telephoning 0118 206 3116 or at medical.information@bayer.co.uk.
==============================================
I took this letter to my GP and asked her to contact them, saying that it is not acceptable to be treated like a child in these matters. In this case, I'm a consumer and I need to be fully informed so as to make a decision regarding my medication and manage the risks. Pharma companies are quite arrogant in this respect.
I'd be interested in hearing back from you or anyone here if they have been able to find out more specific information.
Best wishes
Angie
No dietary restrictions? It's surely been suggested that grapefruit and Rivaroxaban do not get on well.
Hi,
CD Dreamer appears to have the most researched information on this. Have you had any specific advise from Haematologist regarding amounts of food?
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