Rivaroxaban: Drug review

Abstract

Cancer-associated thrombosis is a challenging problem when treating patients with cancer. It is recurrent and difficult to treat because of the increased risk of bleeding. Low-molecular-weight heparin is the standard of care for treating cancer-associated venous thromboembolism/pulmonary embolism (VTE/PE). Recently, there have been emerging data favoring the use of direct oral anticoagulants (DOACs) for treating cancer-associated VTE/PE. They are well tolerated because of oral administration and favorable side effect profile. Rivaroxaban was the first DOAC to be approved by the US Food and Drug Administration in 2012. In this comprehensive review, we discuss the history, chemistry, mechanism of action, indications, dose modifications, and drug–drug interactions of rivaroxaban. We also discuss briefly the results of various clinical trials related to DOACs.

Keywords

• anticoagulant therapy
• cancer-associated thrombosis
• direct oral anticoagulant
• pulmonary embolism
• venous thromboembolism