Kontraindikationen: is contraindicated in patients undergoing hip- or knee-replacement surgery who have hepatic disease associated with coagulopathy and clinically relevant bleeding risk (2).

Revertieren: discontinuation or delaying the next dose may be sufficient, because rivaroxaban has a half-life of 7–11 h (2). Other strategies include mechanical compression, surgical interventions, fluid replacement and hemodynamic support, or transfusions. If these methods are unable to control a bleeding episode, rFVIIa may be considered, but this recommendation is based on data from preclinical studies (2).

Eigenschaften/Wirkungen: is an oral, direct factor Xa inhibitor with more than 10,000-fold greater selectivity for factor Xa than for other related serine proteases (1). In contrast to

LMWH and similar agents, rivaroxaban does not require antithrombin as a cofactor. Direct factor Xa inhibitors, including rivaroxaban, can inhibit free factor Xa, clot-bound factor Xa, and factor Xa bound to the prothrombinase complex unlike indirect factor Xa inhibitors, such as fondaparinux, which are unable to inhibit factor Xa within the prothrombinase complex (2).

Pharmakokinetik: it has an oral bioavailability of 80–100% (for a 10-mg dose), and approximately two thirds of the administered dose undergoes metabolic degradation in the liver. Of this, half is excreted via the kidneys and half via the fecal route. The remaining third is eliminated as unchanged drug in the urine (4).