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 * Prescribing Information
 * Important Safety Information
 * Medication Guide
 * For Healthcare Professionals
 * For Non-US Visitors



Choose Your Condition
 * Adult Conditions:
 * Nonvalvular Atrial Fibrillation (AFib)
 * Deep Vein Thrombosis (DVT)
 * Pulmonary Embolism (PE)
 * Coronary Artery Disease (CAD)
 * Peripheral Artery Disease (PAD)
 * Knee and Hip Replacement
 * Non-Surgical Hospitalization
 * Pediatric Conditions:
 * Pediatric DVT/PE
 * Pediatric Post Fontan

 

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Choose Your Condition
 * Adult Conditions:
 * Nonvalvular Atrial Fibrillation (AFib)
 * Deep Vein Thrombosis (DVT)
 * Pulmonary Embolism (PE)
 * Coronary Artery Disease (CAD)
 * Peripheral Artery Disease (PAD)
 * Knee and Hip Replacement
 * Non-Surgical Hospitalization
 * Pediatric Conditions:
 * Pediatric DVT/PE
 * Pediatric Post Fontan

 * CAD Home
 * CAD & Clot Risk
 * Resources
   * FAQs
   * Doctor Discussion Guide
 * Patient Stories
 * Savings & Support






1-888-XARELTO
 * Prescribing Information
 * Important Safety Information
 * Medication Guide
 * For Healthcare Professionals
 * For Non-US Visitors


XARELTO®, IN COMBINATION WITH LOW-DOSE ASPIRIN, IS THE ONLY ANTICOAGULANT (BLOOD
THINNER) INDICATED TO HELP REDUCE THE RISK OF HEART ATTACK, STROKE, OR
CARDIOVASCULAR DEATH IN ADULTS WITH CAD.


What is XARELTO®?

XARELTO® belongs to a group of medicines called direct oral anticoagulants, or
DOACs for short. Like other DOACs, XARELTO® has no known dietary restrictions,
no requirements for frequent blood tests, and few drug interactions.

XARELTO®, in combination with low-dose aspirin,* is the only anticoagulant
(blood thinner) indicated to help reduce the risk of heart attack, stroke, or
cardiovascular death in adults with CAD.

In fact, in a clinical trial, almost 96% of adults with CAD taking XARELTO® 2.5
mg twice daily, in combination with low-dose aspirin, did not have a heart
attack, stroke, or die from a cardiovascular event.†

*Low-dose aspirin = 75-mg–100-mg tablet once daily.

†The rate of the first event like a stroke, heart attack, or cardiovascular
death was 4.2% for people taking XARELTO® plus aspirin vs 5.6% for aspirin
alone. Patients were followed for an average of 23 months.

Talk to your doctor about XARELTO®

Use this guide to discuss the risks of cardiac events due to CAD with your
doctor, and whether XARELTO® may be right for you.

Start a Doctor Discussion Guide

Take one XARELTO® 2.5 mg tablet twice daily with or without food in combination
with low-dose aspirin (75 mg-100 mg) once daily



Tablets shown not actual size

How do you take XARELTO®?

 * Take XARELTO® 2.5 mg twice daily with or without food in combination with
   aspirin 75 mg–100 mg once daily as instructed by your healthcare professional
 * If you miss a dose of XARELTO®, take your next 2.5 mg dose at your regularly
   scheduled time
 * Remember, there are no known dietary restrictions, unlike warfarin
   (Coumadin®)

Are there any side effects associated with XARELTO® in adults?

Side effects of XARELTO®:

 * Increased risk of bleeding
   * You are likely to bruise more easily and it may take longer for the
     bleeding to stop

Your risk of bleeding increases if you take XARELTO® with other medicines that
also increase your risk of bleeding, such as:

 * * Aspirin or aspirin-containing products
   * Long-term (chronic) use of non-steroidal anti-inflammatory drugs (NSAIDs)
   * Warfarin sodium (Coumadin®, Jantoven®)
   * Any medicine that contains heparin
 * * Clopidogrel (Plavix®)
   * Selective serotonin reuptake inhibitors (SSRIs)
   * Serotonin norepinephrine reuptake inhibitors (SNRIs)
   * Other medicines to prevent or treat blood clots

Always tell your healthcare professional if you experience any side effects
while taking XARELTO®—keeping an open and honest conversation going with your
healthcare professional will help you get the best care. You can use the Doctor
Discussion Guide to help inform your conversation.

Getting started with XARELTO®?

Discover information about getting started with XARELTO®, savings options, and
your condition—all in one helpful starter kit.

Explore the Kit

WHAT IS XARELTO® (rivaroxaban)?

XARELTO® is a prescription medicine used to:

 * reduce the risk of stroke and blood clots in adults who have a medical
   condition called atrial fibrillation that is not caused by a heart valve
   problem. With atrial fibrillation, part of the heart does not beat the way it
   should. This can lead to the formation of blood clots, which can travel to
   the brain, causing a stroke, or to other parts of the body
 * treat blood clots in the veins of your legs (deep vein thrombosis or DVT) or
   lungs (pulmonary embolism or PE)
 * reduce the risk of blood clots from happening again in adults who continue to
   be at risk for DVT or PE after receiving treatment for blood clots for at
   least 6 months
 * help prevent a blood clot in the legs and lungs of adults who have just had
   hip or knee replacement surgery
 * help prevent blood clots in certain adults hospitalized for an acute illness
   and after discharge, who are at risk of getting blood clots because of the
   loss of or decreased ability to move around (mobility) and other risks for
   getting blood clots, and who do not have a high risk of bleeding

XARELTO® is used with low dose aspirin to:

 * reduce the risk of serious heart problems, heart attack and stroke in adults
   with coronary artery disease (a condition where the blood supply to the heart
   is reduced or blocked)
 * reduce the risk of a sudden decrease in blood flow to the legs, major
   amputation, serious heart problems or stroke in adults with peripheral artery
   disease (a condition where the blood flow to the legs is reduced) and
   includes adults who have recently had a procedure to improve blood flow to
   the legs

XARELTO® is used in children to:

 * treat blood clots or reduce the risk of blood clots from happening again in
   children from birth to less than 18 years, after receiving at least 5 days of
   treatment with injectable or intravenous medicines used to treat blood clots
 * help prevent blood clots in children 2 years and older with congenital heart
   disease after the Fontan procedure

XARELTO® was not studied and is not recommended in children less than 6 months
of age who:

 * were less than 37 weeks of growth (gestation) at birth
 * had less than 10 days of oral feeding, or
 * had a body weight of less than 5.7 pounds (2.6 kg)

IMPORTANT SAFETY INFORMATION

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO®?

XARELTO® may cause serious side effects, including:

 * Increased risk of blood clots if you stop taking XARELTO®. People with atrial
   fibrillation (an irregular heart beat) that is not caused by a heart valve
   problem (nonvalvular) are at an increased risk of forming a blood clot in the
   heart, which can travel to the brain, causing a stroke, or to other parts of
   the body. XARELTO® lowers your chance of having a stroke by helping to
   prevent clots from forming. If you stop taking XARELTO®, you may have
   increased risk of forming a clot in your blood.

Do not stop taking XARELTO® without talking to the doctor who prescribes it for
you. Stopping XARELTO® increases your risk of having a stroke. If you have to
stop taking XARELTO®, your doctor may prescribe another blood thinner medicine
to prevent a blood clot from forming.

 * Increased risk of bleeding. XARELTO® can cause bleeding which can be serious
   and may lead to death. This is because XARELTO® is a blood thinner medicine
   (anticoagulant) that lowers blood clotting. During treatment with XARELTO®
   you are likely to bruise more easily, and it may take longer for bleeding to
   stop. You may be at higher risk of bleeding if you take XARELTO® and have
   certain other medical problems.

You may have a higher risk of bleeding if you take XARELTO® and take other
medicines that increase your risk of bleeding, including:

 * Aspirin or aspirin-containing products
 * Long-term (chronic) use of non-steroidal anti-inflammatory drugs (NSAIDs)
 * Warfarin sodium (Coumadin®, Jantoven®)
 * Any medicine that contains heparin
 * Clopidogrel (Plavix®)
 * Selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine
   reuptake inhibitors (SNRIs)
 * Other medicines to prevent or treat blood clots

Tell your doctor if you take any of these medicines. Ask your doctor or
pharmacist if you are not sure if your medicine is one listed above.

Call your doctor or get medical help right away if you or your child develop any
of these signs or symptoms of bleeding:

 * Unexpected bleeding or bleeding that lasts a long time, such as:
   * Nosebleeds that happen often
   * Unusual bleeding from gums
   * Menstrual bleeding that is heavier than normal, or vaginal bleeding
 * Bleeding that is severe or you cannot control
 * Red, pink, or brown urine
 * Bright red or black stools (looks like tar)
 * Cough up blood or blood clots
 * Vomit blood or your vomit looks like “coffee grounds”
 * Headaches, feeling dizzy or weak
 * Pain, swelling, or new drainage at wound sites

 

 * Spinal or epidural blood clots (hematoma). People who take a blood thinner
   medicine (anticoagulant) like XARELTO®, and have medicine injected into their
   spinal and epidural area, or have a spinal puncture, have a risk of forming a
   blood clot that can cause long-term or permanent loss of the ability to move
   (paralysis). Your risk of developing a spinal or epidural blood clot is
   higher if:
   * A thin tube called an epidural catheter is placed in your back to give you
     certain medicine
   * You take NSAIDs or a medicine to prevent blood from clotting
   * You have a history of difficult or repeated epidural or spinal punctures
   * You have a history of problems with your spine or have had surgery on your
     spine

If you take XARELTO® and receive spinal anesthesia or have a spinal puncture,
your doctor should watch you closely for symptoms of spinal or epidural blood
clots.

Tell your doctor right away if you have:

 * back pain
 * tingling
 * numbness
 * muscle weakness (especially in your legs and feet)
 * or loss of control of the bowels or bladder (incontinence)

XARELTO® is not for use in people with artificial heart valves.

XARELTO® is not for use in people with antiphospholipid syndrome (APS),
especially with positive triple antibody testing.

Do not take XARELTO® if you or your child:

 * Currently have certain types of abnormal bleeding. Talk to your doctor before
   taking XARELTO® if you currently have unusual bleeding.
 * Are allergic to rivaroxaban or any of the ingredients of XARELTO®.

Before taking XARELTO®, tell your doctor about all your medical conditions,
including if you or your child:

 * Have ever had bleeding problems
 * Have liver or kidney problems
 * Have antiphospholipid syndrome (APS)
 * Are pregnant or plan to become pregnant. It is not known if XARELTO® will
   harm your unborn baby.
   * Tell your doctor right away if you become pregnant during treatment with
     XARELTO®. Taking XARELTO® while you are pregnant may increase the risk of
     bleeding in you or in your unborn baby.
   * Females who are able to become pregnant: Talk with your doctor about
     pregnancy planning during treatment with XARELTO®. Talk with your doctor
     about your risk for severe uterine bleeding if you are treated with blood
     thinner medicines, including XARELTO®.
   * If you take XARELTO® during pregnancy, tell your doctor right away if you
     have any signs or symptoms of bleeding or blood loss. See “What is the most
     important information I should know about XARELTO®?” for signs and symptoms
     of bleeding.
 * Are breastfeeding or plan to breastfeed. XARELTO® may pass into your breast
   milk. Talk to your doctor about the best way to feed your baby during
   treatment with XARELTO®.

Tell all of your doctors and dentists that you or your child are taking
XARELTO®. They should talk to the doctor who prescribed XARELTO® for you before
you have any surgery, medical or dental procedure.

Tell your doctor about all the medicines you or your child take, including
prescription and over-the-counter medicines, vitamins, and herbal supplements.

Some of your other medicines may affect the way XARELTO® works, causing side
effects. Certain medicines may increase your risk of bleeding. See “What is the
most important information I should know about XARELTO®?”

HOW SHOULD I TAKE XARELTO®?

 * Take XARELTO® exactly as prescribed by your doctor.
 * Do not change your dose or stop taking XARELTO® unless your doctor tells you
   to. Your doctor may change your dose if needed.
 * Your doctor will decide how long you should take XARELTO®.
 * XARELTO® may need to be stopped for one or more days before any surgery or
   medical or dental procedure. Your doctor will tell you when to stop taking
   XARELTO® and when to start taking XARELTO® again after your surgery or
   procedure.
 * If you need to stop taking XARELTO® for any reason, talk to the doctor who
   prescribed XARELTO® to you to find out when you should stop taking it. Do not
   stop taking XARELTO® without first talking to the doctor who prescribes it to
   you.
 * If you have difficulty swallowing XARELTO® tablets whole, talk to your doctor
   about other ways to take XARELTO®.
 * Do not run out of XARELTO®. Refill your prescription of XARELTO® before you
   run out. When leaving the hospital following a hip or knee replacement, be
   sure that you will have XARELTO® available to avoid missing any doses.
 * If you take too much XARELTO®, go to the nearest hospital emergency room or
   call your doctor right away.

If you take XARELTO® for:

 * Atrial Fibrillation that is not caused by a heart valve problem:
   * Take XARELTO® 1 time a day with your evening meal.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Blood clots in the veins of your legs or lungs:
   * Take XARELTO® 1 or 2 times a day as prescribed by your doctor.
   * For the 10-mg dose, XARELTO® may be taken with or without food.
   * For the 15-mg and 20-mg doses, take XARELTO® with food at the same time
     each day.
   * If you miss a dose:
     * If you take the 15-mg dose of XARELTO® 2 times a day (a total of 30 mg of
       XARELTO® in 1 day): Take XARELTO® as soon as you remember on the same
       day. You may take 2 doses at the same time to make up for the missed
       dose. Take your next dose at your regularly scheduled time.
     * If you take XARELTO® 1 time a day: Take XARELTO® as soon as you remember
       on the same day. Take your next dose at your regularly scheduled time.
 * Hip or knee replacement surgery:
   * Take XARELTO® 1 time a day with or without food.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Blood clots in people hospitalized for an acute illness:
   * Take XARELTO® 1 time a day, with or without food, while you are in the
     hospital and after you are discharged as prescribed by your doctor.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Reducing the risk of serious heart problems, heart attack and stroke in
   coronary artery disease:
   * Take XARELTO® 2.5 mg 2 times a day with or without food.
   * If you miss a dose of XARELTO®, take your next dose at your regularly
     scheduled time.
   * Take aspirin 75 to 100 mg once daily as instructed by your doctor.
 * Reducing the risk of a sudden decrease in blood flow to the legs, major
   amputation, serious heart problems or stroke in people with peripheral artery
   disease, including those who have recently had a procedure to improve blood
   flow to the legs:
   * Take XARELTO® 2.5 mg 2 times a day with or without food.
   * If you miss a dose of XARELTO®, take your next dose at your regularly
     scheduled time.
   * Take aspirin 75 to 100 mg once daily as instructed by your doctor.

For children who take XARELTO®:

 * The dose of XARELTO® depends on your child’s body weight and will be
   calculated by your child’s doctor. Your child’s doctor will tell you if
   XARELTO® can be given to your child with or without food.
 * The adult caregiver should give the dose.
 * If your child is taking the tablet, the tablet should be taken whole and
   should not be split in an attempt to provide a lower dose of XARELTO®.
 * If your child is taking the oral suspension, use the syringes provided in the
   original carton. The suspension will be prepared by the pharmacy. See the
   Instructions for Use included in the carton on how to properly give a dose of
   XARELTO® oral suspension to your child.
 * Do not switch between the XARELTO® oral suspension or tablet without first
   talking to your doctor.
 * If your child vomits or spits up:
   * right after or within 30 minutes of taking the oral suspension, give a new
     full dose.
   * more than 30 minutes after taking the oral suspension, do not give the dose
     again. Give the next dose at the regularly scheduled time.
   * if vomiting or spitting up persists, contact your child’s doctor right
     away.
 * If your child misses a dose:
   * If your child is taking XARELTO® 1 time a day, give the dose as soon as you
     remember on the same day. If this is not possible, skip this dose and give
     the next dose at the regularly scheduled time.
   * If your child is taking XARELTO® 2 times a day, give the missed morning
     dose as soon as you remember. You may give the missed morning dose together
     with the evening dose. However, a missed evening dose can only be taken in
     the same evening.
   * If your child is taking XARELTO® 3 times a day, skip the missed dose and
     give the next dose at the regularly scheduled time.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF XARELTO®?

XARELTO® may cause serious side effects:

 * See “What is the most important information I should know about XARELTO®?”

The most common side effect of XARELTO® in adults was bleeding.

The most common side effects of XARELTO® in children include:

 * bleeding
 * vomiting

 * cough
 * inflamed stomach and gut

Call your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088. You may also report side effects to Janssen
Pharmaceuticals, Inc., at 1-800-JANSSEN (1-800-526-7736).

Please read full Prescribing Information, including Boxed Warnings, and
Medication Guide for XARELTO®.

Trademarks are those of their respective owners.

cp-53637v8

© Janssen Pharmaceuticals, Inc. 2022.



This site is published by Janssen Pharmaceuticals, Inc., which is solely
responsible for its contents. The material on this site is intended only as
informational or as an educational aid and it is not intended to be taken as
medical advice. The ultimate responsibility for patient care resides with a
healthcare professional.

This information is intended for the use of patients and caregivers in the
United States and Puerto Rico only. Laws, regulatory requirements, and medical
practices for pharmaceutical products vary from country to country. The
Prescribing Information included here may not be appropriate for use outside the
United States and Puerto Rico.

Third party trademarks used herein are trademarks of their respective owners.

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Last updated 11/22

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WHAT IS XARELTO® (rivaroxaban)?

XARELTO® is a prescription medicine used to:

 * reduce the risk of stroke and blood clots in adults who have a medical
   condition called atrial fibrillation that is not caused by a heart valve
   problem. With atrial fibrillation, part of the heart does not beat the way it
   should. This can lead to the formation of blood clots, which can travel to
   the brain, causing a stroke, or to other parts of the body
 * treat blood clots in the veins of your legs (deep vein thrombosis or DVT) or
   lungs (pulmonary embolism or PE)
 * reduce the risk of blood clots from happening again in adults who continue to
   be at risk for DVT or PE after receiving treatment for blood clots for at
   least 6 months
 * help prevent a blood clot in the legs and lungs of adults who have just had
   hip or knee replacement surgery
 * help prevent blood clots in certain adults hospitalized for an acute illness
   and after discharge, who are at risk of getting blood clots because of the
   loss of or decreased ability to move around (mobility) and other risks for
   getting blood clots, and who do not have a high risk of bleeding

XARELTO® is used with low dose aspirin to:

 * reduce the risk of serious heart problems, heart attack and stroke in adults
   with coronary artery disease (a condition where the blood supply to the heart
   is reduced or blocked)
 * reduce the risk of a sudden decrease in blood flow to the legs, major
   amputation, serious heart problems or stroke in adults with peripheral artery
   disease (a condition where the blood flow to the legs is reduced) and
   includes adults who have recently had a procedure to improve blood flow to
   the legs

XARELTO® is used in children to:

 * treat blood clots or reduce the risk of blood clots from happening again in
   children from birth to less than 18 years, after receiving at least 5 days of
   treatment with injectable or intravenous medicines used to treat blood clots
 * help prevent blood clots in children 2 years and older with congenital heart
   disease after the Fontan procedure

XARELTO® was not studied and is not recommended in children less than 6 months
of age who:

 * were less than 37 weeks of growth (gestation) at birth
 * had less than 10 days of oral feeding, or
 * had a body weight of less than 5.7 pounds (2.6 kg)

IMPORTANT SAFETY INFORMATION

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO®?

XARELTO® may cause serious side effects, including:

 * Increased risk of blood clots if you stop taking XARELTO®. People with atrial
   fibrillation (an irregular heart beat) that is not caused by a heart valve
   problem (nonvalvular) are at an increased risk of forming a blood clot in the
   heart, which can travel to the brain, causing a stroke, or to other parts of
   the body. XARELTO® lowers your chance of having a stroke by helping to
   prevent clots from forming. If you stop taking XARELTO®, you may have
   increased risk of forming a clot in your blood.

Do not stop taking XARELTO® without talking to the doctor who prescribes it for
you. Stopping XARELTO® increases your risk of having a stroke. If you have to
stop taking XARELTO®, your doctor may prescribe another blood thinner medicine
to prevent a blood clot from forming.

 * Increased risk of bleeding. XARELTO® can cause bleeding which can be serious
   and may lead to death. This is because XARELTO® is a blood thinner medicine
   (anticoagulant) that lowers blood clotting. During treatment with XARELTO®
   you are likely to bruise more easily, and it may take longer for bleeding to
   stop. You may be at higher risk of bleeding if you take XARELTO® and have
   certain other medical problems.

You may have a higher risk of bleeding if you take XARELTO® and take other
medicines that increase your risk of bleeding, including:

 * Aspirin or aspirin-containing products
 * Long-term (chronic) use of non-steroidal anti-inflammatory drugs (NSAIDs)
 * Warfarin sodium (Coumadin®, Jantoven®)
 * Any medicine that contains heparin
 * Clopidogrel (Plavix®)
 * Selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine
   reuptake inhibitors (SNRIs)
 * Other medicines to prevent or treat blood clots

Tell your doctor if you take any of these medicines. Ask your doctor or
pharmacist if you are not sure if your medicine is one listed above.

Call your doctor or get medical help right away if you or your child develop any
of these signs or symptoms of bleeding:

 * Unexpected bleeding or bleeding that lasts a long time, such as:
   * Nosebleeds that happen often
   * Unusual bleeding from gums
   * Menstrual bleeding that is heavier than normal, or vaginal bleeding
 * Bleeding that is severe or you cannot control
 * Red, pink, or brown urine
 * Bright red or black stools (looks like tar)
 * Cough up blood or blood clots
 * Vomit blood or your vomit looks like “coffee grounds”
 * Headaches, feeling dizzy or weak
 * Pain, swelling, or new drainage at wound sites

 

 * Spinal or epidural blood clots (hematoma). People who take a blood thinner
   medicine (anticoagulant) like XARELTO®, and have medicine injected into their
   spinal and epidural area, or have a spinal puncture, have a risk of forming a
   blood clot that can cause long-term or permanent loss of the ability to move
   (paralysis). Your risk of developing a spinal or epidural blood clot is
   higher if:
   * A thin tube called an epidural catheter is placed in your back to give you
     certain medicine
   * You take NSAIDs or a medicine to prevent blood from clotting
   * You have a history of difficult or repeated epidural or spinal punctures
   * You have a history of problems with your spine or have had surgery on your
     spine

If you take XARELTO® and receive spinal anesthesia or have a spinal puncture,
your doctor should watch you closely for symptoms of spinal or epidural blood
clots.

Tell your doctor right away if you have:

 * back pain
 * tingling
 * numbness
 * muscle weakness (especially in your legs and feet)
 * or loss of control of the bowels or bladder (incontinence)

XARELTO® is not for use in people with artificial heart valves.

XARELTO® is not for use in people with antiphospholipid syndrome (APS),
especially with positive triple antibody testing.

Do not take XARELTO® if you or your child:

 * Currently have certain types of abnormal bleeding. Talk to your doctor before
   taking XARELTO® if you currently have unusual bleeding.
 * Are allergic to rivaroxaban or any of the ingredients of XARELTO®.

Before taking XARELTO®, tell your doctor about all your medical conditions,
including if you or your child:

 * Have ever had bleeding problems
 * Have liver or kidney problems
 * Have antiphospholipid syndrome (APS)
 * Are pregnant or plan to become pregnant. It is not known if XARELTO® will
   harm your unborn baby.
   * Tell your doctor right away if you become pregnant during treatment with
     XARELTO®. Taking XARELTO® while you are pregnant may increase the risk of
     bleeding in you or in your unborn baby.
   * Females who are able to become pregnant: Talk with your doctor about
     pregnancy planning during treatment with XARELTO®. Talk with your doctor
     about your risk for severe uterine bleeding if you are treated with blood
     thinner medicines, including XARELTO®.
   * If you take XARELTO® during pregnancy, tell your doctor right away if you
     have any signs or symptoms of bleeding or blood loss. See “What is the most
     important information I should know about XARELTO®?” for signs and symptoms
     of bleeding.
 * Are breastfeeding or plan to breastfeed. XARELTO® may pass into your breast
   milk. Talk to your doctor about the best way to feed your baby during
   treatment with XARELTO®.

Tell all of your doctors and dentists that you or your child are taking
XARELTO®. They should talk to the doctor who prescribed XARELTO® for you before
you have any surgery, medical or dental procedure.

Tell your doctor about all the medicines you or your child take, including
prescription and over-the-counter medicines, vitamins, and herbal supplements.

Some of your other medicines may affect the way XARELTO® works, causing side
effects. Certain medicines may increase your risk of bleeding. See “What is the
most important information I should know about XARELTO®?”

HOW SHOULD I TAKE XARELTO®?

 * Take XARELTO® exactly as prescribed by your doctor.
 * Do not change your dose or stop taking XARELTO® unless your doctor tells you
   to. Your doctor may change your dose if needed.
 * Your doctor will decide how long you should take XARELTO®.
 * XARELTO® may need to be stopped for one or more days before any surgery or
   medical or dental procedure. Your doctor will tell you when to stop taking
   XARELTO® and when to start taking XARELTO® again after your surgery or
   procedure.
 * If you need to stop taking XARELTO® for any reason, talk to the doctor who
   prescribed XARELTO® to you to find out when you should stop taking it. Do not
   stop taking XARELTO® without first talking to the doctor who prescribes it to
   you.
 * If you have difficulty swallowing XARELTO® tablets whole, talk to your doctor
   about other ways to take XARELTO®.
 * Do not run out of XARELTO®. Refill your prescription of XARELTO® before you
   run out. When leaving the hospital following a hip or knee replacement, be
   sure that you will have XARELTO® available to avoid missing any doses.
 * If you take too much XARELTO®, go to the nearest hospital emergency room or
   call your doctor right away.

If you take XARELTO® for:

 * Atrial Fibrillation that is not caused by a heart valve problem:
   * Take XARELTO® 1 time a day with your evening meal.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Blood clots in the veins of your legs or lungs:
   * Take XARELTO® 1 or 2 times a day as prescribed by your doctor.
   * For the 10-mg dose, XARELTO® may be taken with or without food.
   * For the 15-mg and 20-mg doses, take XARELTO® with food at the same time
     each day.
   * If you miss a dose:
     * If you take the 15-mg dose of XARELTO® 2 times a day (a total of 30 mg of
       XARELTO® in 1 day): Take XARELTO® as soon as you remember on the same
       day. You may take 2 doses at the same time to make up for the missed
       dose. Take your next dose at your regularly scheduled time.
     * If you take XARELTO® 1 time a day: Take XARELTO® as soon as you remember
       on the same day. Take your next dose at your regularly scheduled time.
 * Hip or knee replacement surgery:
   * Take XARELTO® 1 time a day with or without food.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Blood clots in people hospitalized for an acute illness:
   * Take XARELTO® 1 time a day, with or without food, while you are in the
     hospital and after you are discharged as prescribed by your doctor.
   * If you miss a dose of XARELTO®, take it as soon as you remember on the same
     day. Take your next dose at your regularly scheduled time.
 * Reducing the risk of serious heart problems, heart attack and stroke in
   coronary artery disease:
   * Take XARELTO® 2.5 mg 2 times a day with or without food.
   * If you miss a dose of XARELTO®, take your next dose at your regularly
     scheduled time.
   * Take aspirin 75 to 100 mg once daily as instructed by your doctor.
 * Reducing the risk of a sudden decrease in blood flow to the legs, major
   amputation, serious heart problems or stroke in people with peripheral artery
   disease, including those who have recently had a procedure to improve blood
   flow to the legs:
   * Take XARELTO® 2.5 mg 2 times a day with or without food.
   * If you miss a dose of XARELTO®, take your next dose at your regularly
     scheduled time.
   * Take aspirin 75 to 100 mg once daily as instructed by your doctor.

For children who take XARELTO®:

 * The dose of XARELTO® depends on your child’s body weight and will be
   calculated by your child’s doctor. Your child’s doctor will tell you if
   XARELTO® can be given to your child with or without food.
 * The adult caregiver should give the dose.
 * If your child is taking the tablet, the tablet should be taken whole and
   should not be split in an attempt to provide a lower dose of XARELTO®.
 * If your child is taking the oral suspension, use the syringes provided in the
   original carton. The suspension will be prepared by the pharmacy. See the
   Instructions for Use included in the carton on how to properly give a dose of
   XARELTO® oral suspension to your child.
 * Do not switch between the XARELTO® oral suspension or tablet without first
   talking to your doctor.
 * If your child vomits or spits up:
   * right after or within 30 minutes of taking the oral suspension, give a new
     full dose.
   * more than 30 minutes after taking the oral suspension, do not give the dose
     again. Give the next dose at the regularly scheduled time.
   * if vomiting or spitting up persists, contact your child’s doctor right
     away.
 * If your child misses a dose:
   * If your child is taking XARELTO® 1 time a day, give the dose as soon as you
     remember on the same day. If this is not possible, skip this dose and give
     the next dose at the regularly scheduled time.
   * If your child is taking XARELTO® 2 times a day, give the missed morning
     dose as soon as you remember. You may give the missed morning dose together
     with the evening dose. However, a missed evening dose can only be taken in
     the same evening.
   * If your child is taking XARELTO® 3 times a day, skip the missed dose and
     give the next dose at the regularly scheduled time.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF XARELTO®?

XARELTO® may cause serious side effects:

 * See “What is the most important information I should know about XARELTO®?”

The most common side effect of XARELTO® in adults was bleeding.

The most common side effects of XARELTO® in children include:

 * bleeding
 * vomiting

 * cough
 * inflamed stomach and gut

Call your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088. You may also report side effects to Janssen
Pharmaceuticals, Inc., at 1-800-JANSSEN (1-800-526-7736).

Please read full Prescribing Information, including Boxed Warnings, and
Medication Guide for XARELTO®.

Trademarks are those of their respective owners.

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