Xarelto is the first oral blood thinner approved for anti-coagulation in 60 years, since Warfarin (coumadin) was approved. A variety of injectable options are available; however, the oral route is preferred by many physicians and patients.  Xarelto joins the much older Coumadin as an oral medication. Previouwly Xarelto was only approved for Reduction of Risk of Stroke and Systemic Embolism in Nonvalvular Atrial Fibrillation. In November 2012, the U.S. Food and Drug Administration expanded the approved use of Xarelto (rivaroxaban) to include treating deep vein thrombosis (DVT) or pulmonary embolism (PE), and to reduce the risk of recurrent DVT and PE following initial treatment. .

The approval was approved based on three clinical studies that showed it to be as effective as the enoxaparin and coumadin for treating DVT and PE. With these results, when oral preparations are preferred for tratment of DVT or PE, Xarelto appears to have an advantage over injectable anticoagulants.

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