Xarelto and Alcohol

Xarelto and alcohol

Xarelto and alcohol

Xarelto (rivaroxaban) has been widely advertised as a simple and convenient drug to take since no dietary restrictions are required. But is that also true for alcohol? Other drugs such as Eliquis (apixaban) and Pradaxa (dabigatran) have been also market worldwide as drugs that can be freely taken with any food, but what about drinks? In the Frequently Asked Questions page of the official Xarelto website, the pharmaceutical company clearly explains that patients do not need to change their dietary habits while taking this drug. So, at least in theory, there’s no specific indication that alcohol consumption while taking Xarelto is contraindicated.

Nonetheless, many experts recommend against drinking alcohol while taking any other blood thinner. Since the mechanism through which anticoagulant drugs and alcohol interact is very complex, it was never fully understood. In general, drinking substantial quantities of alcohol must be avoided when under treatment with blood thinners since this substance may intensify the anticoagulant activity of these medicines as it interferes with the blood’s ability to clot. Some researches, in fact, pointed out that small quantities of alcohol may have anticoagulant properties. For this reason, alcohol users under treatment with Warfarin have a higher risk for major bleeding accidents. According to the National Institute of Alcohol Abuse and Alcoholism, even occasional drinking can cause internal haemorrhages, while heavier drinking may increase the risk of both bleeding and blood clots. For some unknown reasons, in fact, higher amounts of this substance may have the opposite effect. The general recommendation is to limit daily alcohol consumption to no more than two glasses of wine (or an equivalent alcohol quantity).

Since no antidote can reverse Xarelto’s effects, even a small trauma can cause a serious bleeding event. Patients treated with this drug risk their very lives just because of a simple fall. Once the bleeding starts, the absence of a proper antidote prevents doctors from staunching the blood flow, leading to serious injuries or even death. Many plaintiffs who were injured after taking this medication filed a lawsuit against Bayer and Janssen Pharmaceutical, since both the two pharmaceutical companies failed to warn the public about the serious threat posed by their product. No warning was ever issued about the increased risk of bleeding associated with drinking alcohol while taking the medication, and since the “one-size-fits-all” dosage cannot be changed or reduced, heavy drinkers are even more at risk than the general population. Alcohol increases the risk of falls, accidents and traumas, further increasing the risk of fatal haemorrhages that cannot be reverted by physicians.

Article written by Dr. Claudio Butticè, PharmD

REFERENCES

  1. Xarelto CarePath. “XARELTO® Frequently Asked Questions – XARELTO® (rivaroxaban)”. xareltocarepath.com.
  2. PubMed Health. “What is anti-clotting medication and how is it used safely? – PubMed Health – National Library of Medicine”. 2014-11-26.
  3. Efird, Lydia M.; Miller, Donald R.; Ash, Arlene S.; Berlowitz, Dan R.; Ozonoff, Al; Zhao, Shibei; Reisman, Joel I.; Jasuja, Guneet K.; Rose, Adam J. (2013-10-01). “Identifying the risks of anticoagulation in patients with substance abuse”. Journal of General Internal Medicine 28 (10): 1333–1339. doi:10.1007/s11606-013-2453-x.
  4. National Institute on Alcohol Abuse and Alcoholism “Mixing Alcohol With Medicines”. pubs.niaaa.nih.gov.
  5. NPS Medicinewise. “Living with rivaroxaban”. http://www.nps.org.au/medicines/heart-blood-and-blood-vessels/anti-clotting-medicines/for-individuals/anticoagulant-medicines/for-individuals/active-ingredients/rivaroxaban/for-individuals/living-with Retrieved 2015-10-15