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North West London Pathology > Tests > Rivaroxaban

Rivaroxaban

Category Haematology >> Specialised Coagulation Services
Test background

Rivaroxaban is a direct oral anticoagulant (DOAC) which exerts its anticoagulant effect through its ability to directly inhibit Coagulation Factor Xa. Plasma Rivaroxaban levels are measured in mass concentration by chromogenic anti-Xa assay using drug-specific calibrators.
Clinical Indications

Recommended as an option for (NICE Guidelines 2016 - KTT16):
- Prevention of VTE after elective hip or knee replacement;
- Treatment and secondary prevention of DVT and/or PE;
- Prevention of stroke and systemic embolism in people with non-valvular AF;
- Prevention of adverse outcomes after acute management of ACS with raised biomarkers;

DOAC monitoring is not generally required; however measurement may be useful where clearance is compromised or where patients are actively bleeding.
Reference range

BCSH Guidelines (2014) Measurement of non-coumarin anticoagulants and their effects on tests of Haemostasis:

Dose Peak (mean and range)  Trough (mean and range); Rivaroxaban 10 mg od 125 ng/mL (91 -195) 9 ng/mL (1 – 38); Rivaroxaban 20 mg od 223 ng/mL (160 – 360) 22 ng/mL (4 – 96);

Peak – 3 hours post-dose
Sample & container required 4.5 mL sodium citrate (pale blue top) adults; 1.8 mL sodium citrate (pale blue top) paediatrics
Turnaround time <24 hours (core hours)
Notes

Please Note: Samples will be rejected if under/over-filled, clotted or haemolysed