Many recent postings have mentioned the desirability of taking this with food containing fat. However looking at the literature available to me I can find no reference to this, The NHS web site does not mention this and most importantly neither does the information leaflet provided by Bayer the manufacturer. Yes it says it should be taken with a meal and the implication is that this is to slow down the rate of passage of the pill through the digestive system so it is properly absorbed but fat is not mentioned. Indeed the Patient alert card, which gives somewhat contradictory advice, goes even further saying that the 5 and 10mg tablets may be taken with or without food.
Where does the fat thing come from?
Written by
Arthursullivan
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It says the 20mg tabs are “better absorbed with a high fat, high calorie meal”. So that appears to be where the high fat advice comes from but only for the 20 mg dose.
Lower doses it appears not important and the lowest doses can be taken with and without food.
Yes, I was told that it needed to be taken with a meal containing g fat , when I was diagnosed during EP studies 5 yrs ago at the Royal Brompton . Prescribed 20mg Rivaroxaban
We (Bob & I) learned that Rivaroxaban is best absorbed with a main meal containing protein and fat at an AF lecture when the question was asked. There was then a bulletin issued but not uncommonly the NHS sites nor the information on the leaflet provided much information about this at all.
A friend of mine used to take their’s at breakfast - and ended up with raised liver enzymes - changed to taking with main meal of an evening and all resolved in a few weeks. Anecdotal I know but my friend’s personal experience.
Thank you for your informative reply. As my morning porridge has scant fat (only from almond milk and ground nuts), I shall change to taking my 15g tablet with my evening meal. It seems to make sense. Thanks to everyone else too. Lots of useful comments here!
The NHS still work with calories (a meaningless index as far as I am concerned) but the figure quoted at the seminar was a meal with at least 500 calories so 2 x toast wouldn’t qualify but add an egg or two - perfect. My favourite breakfast is avacados smashed on toast topped with a poached egg.
Nuts do have a perfect balance of fat and protein - so would depend upon the quantity. If you buy Almond milk it will contain 2 or less almonds so wouldn’t qualify but a handful of freshly chopped almonds would get you there.
Personally I make my own Almond milk for things such as porridge or desserts - real easy - soak a small handful of blanched almonds overnight in water, drain and put in liquidiser with half litre of spring water, pinch of salt and liquidiser very, very well. Perfect and very fresh. You can do similar with oats to make oat milk BUT that would be high in carbs, little or no fat and not great if you are making porridge so not a balanced meal.
The requirement for Pradaxa are very different - yes you need acid to break the gel casing for Pradaxa but Rivaroxaban has entirely different requirements.
Apixaban is the easiest to take. Just a note - Pradaxa has the worst record regarging gastric issues but whatever suits you.
The cardiologist who prescribed it to me said that a fatty meal had been shown to make only a small and inconsequential difference to its absorption but that it should be taken with food. I take mine with breakfast where the only fat is often a nice slice of buttered toast!
I've been taking mine (20 mg) around 8 p.m. with two other pills. After reading info on this forum, and then re-reading the instructions that came with my pills, it seems I should take it with my evening meal for the sake of better absorption (referring only to the 20mg), but the lesser strengths can be taken with or without a meal. I'm slowly weaning myself to take it with the evening meal then.
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