Canada Drug Warehouse

Side Effects of Taking Xarelto

Thursday 26 March 2020
6 minute(s) read

Table of Contents

I. Xarelto: An Overview

II. Side Effects of Xarelto

a. Common Side Effects

b. Serious Side Effects

c. Severe Bleeding Symptoms

d. Notes of Caution

III. Surgery

IV. Medical History

V. Allergies

VI. Pregnancy

VII. Stopping the Medication

VIII. Xarelto and Alcohol

IX. Drug and Supplement Interactions

X. Warnings

a. Warnings for Stopping Treatment

b. Spinal Epidural Blood Clot Warnings

XI. Spinal Blood Clot Risk Factors

XII. Talk to a Licensed Pharmacist

Xarelto: A Brief Overview

Xarelto is an anticoagulant drug that helps to prevent blood clots. Xarelto is often prescribed for people with specific heart rhythm problems, such as non-valvular atrial fibrillation, to prevent blood clots and stroke. Xarelto is also used in patients after hip or knee replacement surgery to prevent blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism). In some cases, a Xarelto prescription is given to people with certain cardiovascular diseases such as coronary artery disease or peripheral artery disease. 

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Side Effects Of Xarelto

Because Xarelto is an anticoagulant, taking the drug may increase your risk of having bleeding complications. This drug may cause mild to serious side effects. It's important to note that this list does not include all the possible side effects. 

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Mild or more common side effects of Xarelto may include:

  • Small bruises, bruising more easily
  • Joint or back pain
  • Bleeding that takes longer to stop such as slight gum bleeding after brushing teeth

If these side effects are mild, they may take a few days or weeks to go away. If the bleeding becomes more severe and does not go away, talk to your doctor.

Serious side effects:

  • Bowel or bladder dysfunction, incontinence ( loss of control of bladder or bowels)
  • Burning, itching, numbness, “pins and needles” feeling
  • Dizziness
  • Headache
  • Difficulty breathing or swallowing
  • Muscle weakness, Leg weakness
  • Paralysis
  • Major bleeding is rare (but may be as high as one person out of 100 each year)

Severe bleeding symptoms include:

  • Bleeding that lasts a long time, or that is severe
  • Frequent nosebleeds
  • Unusual bleeding from gums
  • Heavier than normal menstrual bleeding (or other vaginal bleeding)
  • Bloody stools
  • Coughing up blood
  • Red or black, tarry stools
  • Red, pink, or dark brown urine
  • Vomiting blood, or vomit that looks like coffee grounds
  • Pain, swelling, or new drainage at wound sites [1]

Notes of Caution

There are three Xarelto warnings and precautions of utmost importance. A Xarelto information sheet indicates there is a risk that Xarelto can cause serious and fatal bleeding. Pregnancy-related hemorrhage is also indicated to caution pregnant mothers due to the potential for hemorrhage or emergency delivery. Lastly, for people with prosthetic heart valves, Xarelto use is not recommended. [2]

If you have any signs of bleeding or are concerned about any other side effects you may be experiencing, call your doctor. Tell your doctor about all other medicines and herbal supplements you are taking or have recently used. Some other drugs or supplements may increase your risk of bleeding when using Xarelto.


Previous to undergoing surgery or dental procedures, inform your doctor or dentist that you are taking Xarelto. In some instances, Xarelto may cause excess bleeding.

Medical History

A history of certain medical conditions or medications may put you at risk when taking Xarelto. It is important to know the instances that might not be safe to take this drug. Xarelto may cause an increased risk of excess bleeding, especially if you have:  

  • Hemorrhagic stroke
  • Uncontrolled high blood pressure
  • Ulcer, stomach, or intestinal bleeding
  • A bleeding disorder (inherited or caused by disease)
  • An artificial heart valve, past or present
  • History of liver or kidney disease
  • If you are taking any other medications such as Aspirin, Warfarin, Clopidogrel, antidepressants, etc.[3]


Signs of an allergic reaction may include hives, swelling of facial parts (lips, tongue, throat), and difficulty breathing. Always inform your doctor of any allergies you have, especially to any medications. If you are having an allergic reaction, get emergency help immediately.


pregnant woman holding belly

Taking Xarelto during pregnancy may put the mother and child at risk of excess bleeding. If you are pregnant or plan to become pregnant, tell your doctor before starting Xarelto.

Stopping the Medication

Do not stop or change your dosage of Xarelto without speaking with a doctor first. Stopping the drug suddenly may increase one's risk of stroke or blood clot. 

Xarelto and Alcohol

There may be risks associated with drinking alcohol while taking blood-thinning medications. If you have medical conditions related to either your liver or kidneys, alcohol will affect the metabolism of the blood thinner you are taking. The combination of alcohol and blood-thinning medication may make your blood too thin and can lead to bleeding complications. Speak with your doctor about how much alcohol is, or is not, safe to consume while taking Xarelto. [4]

Drug and Supplement Interactions

orange prescription drug bottles

Many drugs are indicated to interact with Xarelto. Some foods may interact with the drug as well. Always consult a doctor before beginning a prescription of Xarelto to ensure there are no drug interactions with any medications you are currently taking.

While taking Xarelto, use caution with these kinds of drugs: [5]

  • Antiplatelet drugs
  • Anticoagulant drugs
  • HIV drugs
  • Antifungal drugs
  • Tuberculosis drugs
  • Seizure drugs
  • SSRIs
  • SNRIs
  • St. John’s wort (supplement)


Xarelto has black box warnings, which are the most serious warnings. The black box warnings alert patients and doctors about potential side effects and dangers of taking the drug. Please inform yourself of all side effects and dangers prior to taking the drug and always consult a doctor for questions concerning your subscription. 

Warning for stopping treatment

If you stop taking any anticoagulant drug prematurely, such as Xarelto, the risk of stroke and blood clot increases. Do not stop taking this drug without speaking with a doctor beforehand.

Spinal epidural blood clots (hematoma) warning

person demonstrating epidural action on anatomical spine figure

Epidural or spinal hematomas (skin bruise or blood clot) have occurred in patients taking Xarelto who are receiving neuraxial anesthesia (local anesthetic place around the nerves of the central nervous system) or are undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. [1]

Spinal Blood Clot Risk Factors

If you undergo a spinal tap or receive an epidural, there is a chance that Xarelto may cause a severe blood clot around your spinal cord. Always inform your doctor that you are taking Xarelto. This form of blood clot could cause long-term paralysis, and is more likely to occur in these instances: [3]

  • You are using other medicines to prevent blood clots
  • You are taking any type of NSAID drugs
  • You have recently had an epidural or spinal tap, or a have a history of repeated spinal taps
  • You have a history of spinal surgery
  • You have a spinal catheter
  • You have a genetic spinal defect

Talk to a Licensed Pharmacist at Canada Drug Warehouse

After learning about possible side effects and drug interactions associated with your new prescription, it can feel overwhelming.

Did you know that you can request a consultation with a licensed pharmacist when you place an order with Canada Drug Warehouse? Your health and safety is of our utmost importance. We are happy to connect patients with a pharmacist via our consultation call-back service to answer any questions or concerns you may have.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.