Laboratory Medicine Program

Rivaroxaban
(Xarelto, Direct Xa Inhibitor)

Clinical Decription:
Direct factor Xa inhibitors are synthetically derived and directly inhibit factor Xa. They are called 'direct' because unlike heparin, LMWH and fondaparinux, they do not require antithrombin to inhibit their target. Direct Xa inhibitors include rivaroxaban, apixaban and edoxaban, which are used for the prevention of stroke related to non-valvular atrial fibrillation and in the prophylaxis and/or treatment of venous thromboembolism. Rivaroxaban, apixaban and edoxaban do not require routine monitoring. Since the drug inhibits factor Xa, PT and aPTT may be variably affected.

Method: Chromogenic; Siemens Sysmex CS-5100

Component Tests Used: n/a

Reference Ranges Used:
There are currently no established therapeutic reference ranges for Rivaroxaban. Clinical thresholds for the efficacy and safety of Rivaroxaban related to drug concentrations are not known. The result must be interpreted within the clinical context.

Specimen Type: Citrated plasma
Collected In: 3.2% Sodium Citrate
Volume: 1.0 mL (minimum: 1.0 mL)

Shipping: Send frozen on dry ice.

Special Instructions: Patient should be fasting, if possible. The specimen must be double-centrifuged to obtain a platelet-poor plasma specimen (Plt <10x10E9/L): 1. Immediately centrifuge specimen at 1500xG for 10 minutes. 2. Separate the plasma from the platelet/buffy coat and transfer into a clean plastic tube. 3. Centrifuge the separated plasma at 1500xG for 10 minutes. 4. Transfer 1.0 to 2.0 mL of the double-centrifuged plasma into a clean plastic tube, leaving approx. 200 uL for discard. 5. Freeze plasma aliquot immediately for storage. Maintain frozen for shipping and handling.

Testing Schedule(s): Daily.

Turnaround Time: 1 day

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