Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C19H18ClN3O5S |
| Molecular Weight | 435.881 |
| Optical Activity | ( - ) |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
ClC1=CC=C(S1)C(=O)NC[C@H]2CN(C(=O)O2)C3=CC=C(C=C3)N4CCOCC4=O
InChI
InChIKey=KGFYHTZWPPHNLQ-AWEZNQCLSA-N
InChI=1S/C19H18ClN3O5S/c20-16-6-5-15(29-16)18(25)21-9-14-10-23(19(26)28-14)13-3-1-12(2-4-13)22-7-8-27-11-17(22)24/h1-6,14H,7-11H2,(H,21,25)/t14-/m0/s1
| Molecular Formula | C19H18ClN3O5S |
| Molecular Weight | 435.881 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
DescriptionCurator's Comment: description was created based on several sources, including
http://www.biospace.com/News/bayer-healthcares-xarelto-rivaroxaban-becomes/244131
Curator's Comment: description was created based on several sources, including
http://www.biospace.com/News/bayer-healthcares-xarelto-rivaroxaban-becomes/244131
Rivaroxaban (trade name Xarelto) is an oral anticoagulant. It is the first available orally active direct factor Xa inhibitor. Upon oral administration, rivaroxaban selectively binds to both free factor Xa and factor Xa bound in the prothrombinase complex. This interferes with the conversion of prothrombin (factor II) to thrombin and eventually prevents the formation of cross-linked fibrin clots. Rivaroxaban does not affect existing thrombin levels. Activation of factor X to factor Xa (FXa) via the intrinsic and extrinsic pathways plays a central role in the cascade of blood coagulation. Xarelto is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, treatment and prophylaxis of deep vein thrombosis (DVT) which may lead to PE in patients undergoing knee or hip replacement surgery, pulmonary embolism (PE) and for the reduction in the risk of recurrence of deep vein thrombosis and of pulmonary embolism following initial 6 months treatment for DVT and/or PE.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/23999929
Curator's Comment: Rivaroxaban is distributed heterogeneously to tissues and organs, exhibiting only moderate tissue affinity and does not substantially penetrate the blood-brain barrier.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL244 |
0.4 nM [Ki] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Secondary | XARELTO Approved UseIndicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, for the treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for the reduction in the risk of recurrence of DVT and of PE for the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery. Launch Date2011 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
138.4 μg/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23999929/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
RIVAROXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
1.114 μg × h/L EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23999929/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
RIVAROXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
10.77 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23999929/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
RIVAROXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
9 h |
20 mg 1 times / day unknown, oral dose: 20 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
RIVAROXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
5% |
20 mg 1 times / day unknown, oral dose: 20 mg route of administration: Oral experiment type: UNKNOWN co-administered: |
RIVAROXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
80 mg single, oral Highest studied dose |
healthy, 19-45 |
|
50 mg single, oral Studied dose |
healthy, 60-76 |
|
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
Disc. AE: Bleeding... AEs leading to discontinuation/dose reduction: Bleeding (grade 3-5, 4.3%) Sources: |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
Disc. AE: Bleeding... AEs leading to discontinuation/dose reduction: Bleeding (2%) Sources: |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Disc. AE: Spinal epidural hematoma... AEs leading to discontinuation/dose reduction: Spinal epidural hematoma Sources: |
20 mg 2 times / day multiple, oral Recommended Dose: 20 mg, 2 times / day Route: oral Route: multiple Dose: 20 mg, 2 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
Disc. AE: Bleeding... AEs leading to discontinuation/dose reduction: Bleeding (1.7%) Sources: |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Bleeding | grade 3-5, 4.3% Disc. AE |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
| Bleeding | 2% Disc. AE |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
| Spinal epidural hematoma | Disc. AE | 20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
| Bleeding | 1.7% Disc. AE |
20 mg 2 times / day multiple, oral Recommended Dose: 20 mg, 2 times / day Route: oral Route: multiple Dose: 20 mg, 2 times / day Sources: |
unhealthy Health Status: unhealthy Sex: M+F Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no | |||
Page: 17.0 |
no |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 9.0 |
yes | |||
Page: 9.0 |
yes | |||
Page: 9.0 |
yes | yes (co-administration study) Comment: ketoconazole increased cmax of rivaroxaban 0.7x, auc 1.6x Page: 9.0 |
||
Page: 9.0 |
yes | yes (co-administration study) Comment: ketoconazole increased cmax of rivaroxaban 0.7x, auc 1.6x Page: 9.0 |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 248.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Rivaroxaban: a novel, oral, direct factor Xa inhibitor. | 2009-02 |
|
| Comparative pharmacodynamics and pharmacokinetics of oral direct thrombin and factor xa inhibitors in development. | 2009 |
|
| [Summary and perspectives. Rivaroxaban]. | 2008-12 |
|
| [Rivaroxaban (Xarelto): efficacy and safety]. | 2008-12 |
|
| [Perioperative venous thromboembolism prophylaxis: short review and recommendations]. | 2008-12 |
|
| [Rivaroxaban: clinical pharmacology]. | 2008-12 |
|
| [Rivaroxaban: a decisive step forward in the management of postoperative thromboembolic disease?]. | 2008-12 |
|
| [Pharmacology of heparins and direct anticoagulants]. | 2008-12 |
|
| Rivaroxaban for thromboprophylaxis. | 2008-11-13 |
|
| Rivaroxaban for thromboprophylaxis. | 2008-11-13 |
|
| Rivaroxaban for thromboprophylaxis. | 2008-11-13 |
|
| Rivaroxaban for thromboprophylaxis. | 2008-11-13 |
|
| Controversies in the antiphospholipid syndrome: can we ever stop warfarin? | 2008-11-11 |
|
| [New oral anticoagulants: molecular characteristics, mechanisms of action, pharmacokinetics and pharmacodynamics]. | 2008-11 |
|
| [Anaesthesia and thromboembolic disease]. | 2008-11 |
|
| [Thromboembolic disease in orthopedic surgery]. | 2008-11 |
|
| [Rivaroxaban. The first factor Xa inhibitor]. | 2008-11 |
|
| Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding in knee arthroplasty. | 2008-10-22 |
|
| Thromboprophylaxis with rivaroxaban or enoxaparin did not differ for major bleeding or other safety outcomes in hip arthroplasty. | 2008-10-22 |
|
| Preventing venous thromboembolism through risk assessment approaches. | 2008-10-02 |
|
| Orally administered factor xa inhibitor, rivaroxaban: a novel thromboembolic prophylaxis agent. | 2008-10 |
|
| [Always more amputations in Germany?]. | 2008-10 |
|
| More effective, simpler-to-use clot-buster is on the way. Clot-prevention drug could save lives after joint replacement. | 2008-10 |
|
| Rivaroxaban: future in anticoagulation practice? | 2008-10 |
|
| [Prophylaxis of venous thromboembolism]. | 2008-10 |
|
| [Anticoagulation in atrial fibrillation]. | 2008-10 |
|
| Dose-escalation study of the pharmacokinetics and pharmacodynamics of rivaroxaban in healthy elderly subjects. | 2008-10 |
|
| Differences in urinary prothrombin fragment 1 + 2 levels after total hip replacement in relation to venous thromboembolism and bleeding events. | 2008-10 |
|
| Rivaroxaban--an oral, direct Factor Xa inhibitor--has potential for the management of patients with heparin-induced thrombocytopenia. | 2008-10 |
|
| Polyphosphate as a general procoagulant agent. | 2008-10 |
|
| A dose-ranging study evaluating once-daily oral administration of the factor Xa inhibitor rivaroxaban in the treatment of patients with acute symptomatic deep vein thrombosis: the Einstein-DVT Dose-Ranging Study. | 2008-09-15 |
|
| Determination of rivaroxaban--a novel, oral, direct Factor Xa inhibitor--in human plasma by high-performance liquid chromatography-tandem mass spectrometry. | 2008-09-01 |
|
| New developments in anticoagulation for atrial fibrillation. | 2008-09 |
|
| Population pharmacokinetics and pharmacodynamics of once- and twice-daily rivaroxaban for the prevention of venous thromboembolism in patients undergoing total hip replacement. | 2008-09 |
|
| Rivaroxaban: an oral direct inhibitor of factor Xa. | 2008-08-15 |
|
| Potent anticoagulants are associated with a higher all-cause mortality rate after hip and knee arthroplasty. | 2008-08 |
|
| Selective factor Xa inhibition for thromboprophylaxis. | 2008-07-05 |
|
| Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty: a double-blind, randomised controlled trial. | 2008-07-05 |
|
| New anticoagulants--the path from discovery to clinical practice. | 2008-06-26 |
|
| Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. | 2008-06-26 |
|
| Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty. | 2008-06-26 |
|
| Gateways to clinical trials. | 2008-06 |
|
| [Hematology 2008]. | 2008-06 |
|
| Rivaroxaban, an oral direct factor Xa inhibitor. | 2008-06 |
|
| Gateways to clinical trials. | 2008-04 |
|
| New issues in oral anticoagulants. | 2008 |
|
| New compounds in the management of venous thromboembolism after orthopedic surgery: focus on rivaroxaban. | 2008 |
|
| Brave new world: the current and future use of novel anticoagulants. | 2008 |
|
| The top 4 advances in antithrombotic care in the last year. | 2008 |
|
| Pharmacological strategies for inhibition of thrombin activity. | 2008 |
Sample Use Guides
15 mg and 20 mg tablets with food; take 10 mg tablets with or without food. For patients with CrCl >50 mL/min 20 mg orally, once daily and for patients with CrCl 15 - 50 mL/min 15 mg orally, once daily with the evening meal.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/?term=23578206
To evaluate the influence of prothrombin complex concentrate (PCC) on the anticoagulant effects of rivaroxaban as measured by prothrombin time (PT) and thrombin generation tests plasma and whole blood samples from healthy volunteers were spiked with Rivaroxaban (up to 800 ug/L) and prothrombin complex concentrate (PCC) was added to these samples in concentration ranges as used clinically to reverse the effects of vitamin K antagonists. Prothrombin complex concentrate does not neutralize the
lengthening effect on PT and TGT lag time/T-Lag of rivaroxaban anticoagulated blood in vitro; however, total thrombin potential could be normalized.
| Substance Class |
Chemical
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9NDF7JZ4M3
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Validated (UNII)
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EMA ASSESSMENT REPORTS |
XARELTO (AUTHORIZED: ARTHROPLASTY, REPLACEMENT)
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NCI_THESAURUS |
C263
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WHO-ATC |
B01AF01
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NDF-RT |
N0000175637
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EMA ASSESSMENT REPORTS |
XARELTO (AUTHORIZED: VENOUS THROMBOEMBOLISM)
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WHO-ATC |
B01AX06
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WHO-VATC |
QB01AF01
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LIVERTOX |
NBK548015
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LOINC |
74871-5
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DTXSID3057723
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C77995
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DB06228
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m9638
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9NDF7JZ4M3
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RIVAROXABAN
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1114195
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Rivaroxaban
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SUB29263
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METABOLIC ENZYME -> SUBSTRATE | |||
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RACEMATE -> ENANTIOMER |
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TARGET -> INHIBITOR |
COMPETITIVE INHIBITOR
IC50
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TARGET -> INHIBITOR |
COMPETITIVE INHIBITOR
Ki
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METABOLIC ENZYME -> SUBSTRATE | |||
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TRANSPORTER -> SUBSTRATE | |||
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BINDER->LIGAND |
BINDING
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TARGET -> INHIBITOR | |||
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TRANSPORTER -> SUBSTRATE |
| Related Record | Type | Details | ||
|---|---|---|---|---|
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METABOLITE -> PARENT |
MINOR
FECAL; URINE
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METABOLITE -> PARENT |
IN-VITRO
FECAL; URINE
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METABOLITE -> PARENT |
MINOR
FECAL; URINE
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METABOLITE -> PARENT | |||
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METABOLITE -> PARENT |
excreta 2.5% radio acitivty
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METABOLITE -> PARENT |
IN-VIVO
FECAL; URINE
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METABOLITE -> PARENT |
| Related Record | Type | Details | ||
|---|---|---|---|---|
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
|
||
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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IMPURITY -> PARENT |
CHROMATOGRAPHIC PURITY (HPLC/UV)
EP
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| Related Record | Type | Details | ||
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ACTIVE MOIETY |
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| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| Biological Half-life | PHARMACOKINETIC |
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| Volume of Distribution | PHARMACOKINETIC |
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