Concurrent use of anticoagulation

The usual dosages of unfractionated heparin, LMWH, direct thrombin inhibitors, or fondaparinux during haemodialysis for regional anticoagulation for haemodialysis are allowed. There is no need to stop or withhold the study medication. Rivaroxaban cannot be dialysed. Therefore, the study medication can be taken twice daily regardless of the timing of haemodialysis.

For participants who develop a need for anticoagulant therapy (e.g. thromboprophylaxis for major surgery or acute medical illness, acute VTE), the study medication must be temporarily discontinued.

For therapeutic anticoagulation, the required anticoagulant therapy can be started anytime without regard to the timing of the most recent dose of the study medication.

For prophylactic anticoagulation, the required anticoagulant therapy should be started at the time that the next dose of the study medication is due.

The study medication can be restarted in participants who no longer have a need for anticoagulant therapy (e.g. after the completion of thromboprophylaxis, or anticoagulant treatment for VTE). The study medication should not be restarted until at least 12 hours after last administration of any anticoagulant.

For participants who develop a need for long-term need for anticoagulant therapy (e.g. atrial fibrillation, mechanical valve replacement), the study medication must be discontinued. Participants who discontinue the study medication will continue with regular study visits.

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