Xarelto Is a Prescription Blood Thinner Used to Prevent and Treat Blood Clots

Xarelto (Rivaroxaban) is a prescription anticoagulant — commonly called a blood thinner — that prevents dangerous blood clots from forming in your body. It belongs to a class of medications called direct oral anticoagulants (DOACs) and is one of the most widely prescribed blood thinners in the United States.

What Is Xarelto?

Here are the basics:

• Brand name: Xarelto
• Generic name: Rivaroxaban
• Drug class: Direct Factor Xa Inhibitor (DOAC)
• Manufacturer: Janssen Pharmaceuticals (a Johnson & Johnson company)
• FDA approved: Yes, for multiple indications
• Controlled substance: No — Xarelto is not a controlled substance
• Available forms: Oral tablets (2.5 mg, 10 mg, 15 mg, 20 mg) and oral suspension (1 mg/mL)

Xarelto works by blocking Factor Xa, a key protein in the blood clotting process. For a plain-English explanation of how it works, read our post on Xarelto's mechanism of action.

What Is Xarelto Used For?

Xarelto is FDA-approved for a wide range of conditions:

• Atrial fibrillation (AFib) — Reduces the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
• Deep vein thrombosis (DVT) — Treats blood clots in the deep veins, usually in the legs.
• Pulmonary embolism (PE) — Treats blood clots that travel to the lungs.
• Prevention of recurrent DVT and PE — Helps prevent blood clots from coming back.
• DVT prevention after surgery — Used after hip or knee replacement to prevent post-surgical blood clots.
• Coronary artery disease (CAD) — Reduces the risk of major cardiovascular events.
• Peripheral artery disease (PAD) — Reduces the risk of major thrombotic events.
• Hospitalized medical patients — Prevents blood clots in acutely ill patients at risk for clotting complications.

How Is Xarelto Taken?

How you take Xarelto depends on your dose:

• 15 mg and 20 mg tablets: Must be taken with food (specifically with the evening meal for atrial fibrillation) to ensure the drug is fully absorbed.
• 2.5 mg and 10 mg tablets: Can be taken with or without food.
• Swallow tablets whole. If you can't swallow a tablet, it can be crushed and mixed with applesauce, then taken immediately.
• Do not stop suddenly. Xarelto has a boxed warning: stopping abruptly increases the risk of blood clots, stroke, and pulmonary embolism. Always talk to your doctor before changing or stopping your dose.

The typical dose range is 2.5 mg twice daily to 20 mg once daily, depending on the condition being treated. Your doctor will determine the right dose for you based on your diagnosis and kidney function.

Common Dosing by Condition

• Atrial fibrillation: 20 mg once daily with the evening meal (15 mg if kidney function is reduced)
• DVT/PE treatment: 15 mg twice daily for 21 days, then 20 mg once daily
• DVT prevention after surgery: 10 mg once daily
• CAD/PAD: 2.5 mg twice daily (usually combined with low-dose aspirin)

Who Should Not Take Xarelto?

Xarelto is not safe for everyone. You should not take Xarelto if you have:

• Active pathological bleeding — such as a bleeding ulcer or intracranial hemorrhage.
• Severe allergy to Rivaroxaban — if you've had a serious allergic reaction to Xarelto before.
• Prosthetic heart valves — Xarelto has not been studied and is not recommended for this group.
• Triple-positive antiphospholipid syndrome — a blood clotting disorder where Xarelto may increase clotting risk.

Use caution if you have kidney impairment, liver disease, or a BMI over 40. Your doctor should know your full medical history before prescribing Xarelto. For information on medications that interact with Xarelto, see our drug interactions guide.

How Much Does Xarelto Cost?

Cost is a real concern for many Xarelto patients. Here's the landscape in 2026:

• Brand-name cash price: $500–$650 per month for 30 tablets without insurance.
• Generic (Rivaroxaban): Only the 2.5 mg strength has a generic available (approved March 2025, made by Lupin and Taro). Generic 2.5 mg tablets can cost as low as $45–$80 per month with discount coupons. Higher-strength generics are not yet available.
• Medicare price: Starting in January 2026, Medicare has negotiated a price of $197 per month for Xarelto under the Inflation Reduction Act.
• Manufacturer savings: The Xarelto withMe Savings Card by Janssen may let commercially insured patients pay as little as $0 per fill. Not available for government insurance.
• Patient assistance: The Johnson & Johnson Patient Assistance Foundation provides free Xarelto to qualifying uninsured or underinsured patients. Apply through Janssen CarePath at 1-800-526-7736.

For a complete breakdown of savings options, read our guide on how to save money on Xarelto.

Final Thoughts

Xarelto is one of the most versatile and widely used anticoagulants available today. It treats and prevents blood clots across a wide range of conditions, requires no routine blood monitoring (unlike warfarin), and is available in multiple dose strengths. If your doctor has prescribed Xarelto — or you think you might need it — understanding the basics helps you take an active role in your treatment.

Ready to fill your prescription? Use Medfinder to check which pharmacies near you have Xarelto in stock.