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Possible Food & Drug Interactions with Xarelto

Wednesday 28 July 2021
4 minute(s) read

Table of Contents

I. What is Xarelto?

II. What Foods Do I Have to Avoid with Xarelto?

III. Possible Drug Interactions with Xarelto

IV. Benefits and Risks of Xarelto

What is Xarelto?

Xarelto (rivaroxaban) is a new and popular blood thinner used to treat and prevent blood clots in those with atrial fibrillation. Xarelto is also used to prevent blood clots from forming in patients confined to bed rest during hospital stays, often after a hip or knee replacement surgery. Other blood clot-related conditions, such as deep vein thrombosis (DVT) and pulmonary embolus (PE), can also be treated with rivaroxaban. [1]

Rivaroxaban works by targeting a substance in the body known as Factor Xa (FXa). This substance is an enzyme synthesized in the liver and is responsible for coagulation (blood clotting). By inhibiting FXa, Xarelto prevents the formation of blood clots. [2]

Although Xarelto is categorized as a blood thinner, a more accurate name for this drug would be an anticoagulant. This is because Xarelto, like other drugs in its category, does not actually thin the blood, so it cannot dissolve existing clots. Instead, Xarelto reduces the body’s ability to solidify blood, preventing new clots and existing clots from growing larger. [2]

an assortment of different foods

What Foods Do I Have to Avoid with Xarelto?

Unlike other anticoagulants like warfarin, Xarelto does not have nearly as many food interactions. It is one of the main reasons Xarelto is the first choice for many patients looking for a blood thinner.

Traditionally, you could not continue eating several healthy foods if you were taking an anticoagulant. Vitamin K plays an integral role in the blood clotting process, so foods rich in vitamin K used to be out of the question. With Xarelto, you can still enjoy leafy vegetables such as kale and spinach. [3]

Although rivaroxaban does not interact with vitamin K, Xarelto does not have zero dietary restrictions. Studies by the Canadian Medical Association Journal (CMAJ) and the Food and Drugs Administration (FDA) show that grapefruit and grapefruit juice can increase plasma concentrations of Xarelto in the body. [3]

If you are taking Xarelto, avoid food interactions by steering clear of grapefruit and grapefruit products. Additionally, consult your doctor if you are uncertain whether a food item will interact. [3]  

Possible Drug Interactions with Xarelto

Xarelto has few food interactions, but how does it compare to other blood thinners on the market?

The best way to avoid drug interactions is to be transparent with your doctor about the medications you are taking. Your doctor will be best able to recognize if two or more drugs should not be taken concurrently. Drug interactions can change how your medications work and increase the risk of severe side effects. The first thing to keep in mind is that different blood thinners should not be taken at the same time.

Xarelto is known to interact with antidepressants such as fluoxetine and selective serotonin reuptake inhibitors (SSRIs) like venlafaxine and desvenlafaxine. This type of interaction may cause excessive bruising or an emergency bleeding event.


a man smiling

Xarelto may also interact with drugs that interfere with how rivaroxaban is removed from the body. This type of interaction may affect Xarelto’s efficacy. Drugs that interact with Xarelto in this way include:

  • Cobicistat
  • Conivaptan
  • Antifungals (itraconazole, ketoconazole)
  • Rifamycin, rifampin
  • HIV protease inhibitors (lopinavir, ritonavir)
  • Antiseizure medication (carbamazepine, phenytoin, phenobarbital

This list is not exhaustive and may not include every possible Xarelto drug interaction. Always talk to your healthcare provider before taking rivaroxaban. [1]

Benefits and Risks of Xarelto

Xarelto is a great option for many people looking for an anticoagulant. However, it is always important to understand the potential side effects. Like other blood thinners, Xarelto may lead to adverse bleeding events because the body’s clotting factor has been blocked. If you experience any of the following symptoms, contact your doctor.

  • Frequent nose bleeds
  • Unusual bleeding from the gums
  • Heavier than usual vaginal or menstrual bleeding
  • Red or brown urine
  • Vomiting blood
  • Headaches, weakness, or dizziness
  • Muscle spasms, itching, or breathing difficulties

If you start with Xarelto, it is important not to prematurely discontinue its use. Suddenly discontinuing treatment with Xarelto can result in adverse blood clot complications such as a stroke. If you wish to stop treatment, talk to your doctor. [2]

Xarelto (rivaroxaban) is one of the newest anticoagulants on the market and offers many advantages to traditional blood thinners. By avoiding food and drug interactions, you will have a better chance of reaping the drug’s benefits and avoiding complications. Consult your doctor to better understand the benefits and risks of Xarelto. When you're ready, you can order your medications online though an online pharmacy referral service like Canada Med Stop at discount prices.

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.