Rivaroxaban

BNF:
2.8.2
Status:
Do Not Prescribe (DNP), Grey - after consultant/specialist initiation, Red, Green, Green - after consultant/specialist initiation
Decision Date:
None
 

Comments

RED:1,5 NICE TA170: prevention of VTE after hip or knee replacement in adults

GREEN: NICE TA256for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation as per local guidance. Preferred first line choice. Once daily administration. (Decision date - November 2024)

GREEN (following specialist initiation): for the following indications as per SPC:

  • NICE TA261: Venous thromboembolism (treatment and long-term secondary prevention).  Rivaroxaban - a recommended option for treating DVT, and to help prevent a pulmonary embolism or another DVT.  (Decision date - March 2013)
  • NICE TA287: for treating pulmonary embolism and preventing recurrent venous thromboembolism (decision date - August 2013)
  • 2.5mg preparation. NICE TA335: GREEN specialist initiation for patients commenced on rivaroxaban 2.5mg tablet, with a specified 12 month stop date. Indicated as per NICE TA335: preventing adverse outcomes after acute management of acute coronary syndrome. (Decision date May 2015, further decision – August 2023)

GREY 3,6 after consultant/specialist initiation: NICE TA607: Rivaroxaban 2.5mg + aspirin for the prevention of atherothrombotic events in people with coronary or peripheral artery disease. Treatment should only be started after an informed discussion with the patient about the risks and benefits of treatment. (Decision date - November 2019)

DNP: Xarelto brand. Generic preparation available. For patients that are already on Xarelto prior to the DNP classification, treatment should be continued until the next clinical review where their NHS clinician will decide whether it is appropriate to switch. (Decision date November 2024)

 

Do Not Prescribe (DNP) Drug Classifications

  • 5: Less cost-effective than current standard therapy

Grey Drug Classifications

  • 3: Known excess of significant adverse events compared with standard therapy
  • 6: NICE guidance

Red Drug Classifications

  • 1: Requiring specialist assessment to enable patient selection, initiation and ongoing treating
  • 5: Is new to clinical practice and unfamiliar, necessitating a period of accumulation of experience, firstly (and most rapidly) by consultants/specialists

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Derby and Derbyshire ICB

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