Nka anticagulant nshya yo mu kanwa, rivaroxaban yakoreshejwe cyane mukurinda no kuvura indwara zifata imitsi ya tromboembolique no kwirinda indwara yimitsi muri fibrillation idafite agaciro. Kugirango ukoreshe rivaroxaban mu buryo bushyize mu gaciro, ugomba kumenya byibuze izi ngingo 3.
I. Itandukaniro riri hagati ya rivaroxaban nizindi anticoagulants zo mu kanwa Kugeza ubu, imiti igabanya ubukana ikoreshwa mu kanwa harimo warfarin, dabigatran, rivaroxaban nibindi. Muri byo, dabigatran na rivaroxaban bita anticoagulants yo mu kanwa (NOAC). Warfarin, cyane cyane igira ingaruka zayo zo kurwanya antikagulant muguhagarika synthesis yibintu bya coagulation II (prothrombin), VII, IX na X. Warfarin nta ngaruka igira kubintu byoguhinduranya bityo ikaba itangira ibikorwa buhoro. Dabigatran, cyane cyane binyuze mukubuza ibikorwa bya trombine (prothrombin IIa), bigira ingaruka mbi. Rivaroxaban, cyane cyane binyuze mukubuza ibikorwa bya coagulation factor Xa, bityo bikagabanya umusaruro wa trombine (coagulation factor IIa) kugirango igire ingaruka mbi, ntabwo bigira ingaruka kumikorere ya trombine imaze gukorwa, bityo ntigire ingaruka nke mumikorere ya hemostasis ya physiologique.
2. Ibimenyetso byerekana ivuriro rya rivaroxaban imitsi yimitsi ya endoteliyale, umuvuduko wamaraso, umuvuduko ukabije wamaraso nibindi bintu bishobora gutera trombose. Mu barwayi bamwe b'amagufwa, kubaga ikibuno cyangwa ivi bigenda neza cyane, ariko bahita bapfa iyo bavuye mu buriri nyuma y'iminsi mike babagwa. Ibi birashoboka kubera ko umurwayi yagize trombose ndende nyuma yo kubagwa hanyuma agapfa azize embolisme yimpaha yatewe na trombus idacitse. Rivaroxaban, yemerewe gukoreshwa mu barwayi bakuze barimo kubagwa ikibuno cyangwa ivi kugira ngo birinde indwara ya trombose (VTE); no kuvura imitsi yimbitse (DVT) kubantu bakuru kugirango bagabanye ibyago byo kongera kwandura DVT na embolisme yimpyisi (PE) nyuma ya DVT ikaze. Fibrillation ya Atriale ni umutima udasanzwe w'umutima ufite ubwiganze bugera kuri 10% mubantu barengeje imyaka 75. Abarwayi bafite fibrillation atriyale bafite imyumvire yo kumaraso guhagarara muri atriya no gukora uturemangingo, dushobora gutandukana kandi bigatera indwara yubwonko. Rivaroxaban, yaremejwe kandi irasabwa abarwayi bakuze bafite fibrillation ya atrivivulaire yo kugabanya ibyago byo kwandura indwara ya stroke na embolism sisitemu. Imikorere ya rivaroxaban ntabwo iri munsi ya warfarin, indwara yo kuva amaraso munda yo mu nda ni mike ugereranije na warfarin, kandi ntibisabwa buri gihe kugenzura ubukana bwa anticoagulation, nibindi.
3. Mu bihe bidasanzwe, nko gukekwa kurenza urugero, ibintu bikomeye byo kuva amaraso, kubagwa byihutirwa, kubaho kwa tromboembolique cyangwa gukekwa kutubahiriza amategeko, kugena igihe cya prothrombine (PT) cyangwa kugena ibikorwa birwanya Xa birasabwa. Inama: Rivaroxaban ikoreshwa cyane na CYP3A4, ikaba insimburangingo ya poroteyine itwara P-glycoproteine ​​(P-gp). Kubwibyo, rivaroxaban ntigomba gukoreshwa ifatanije na itraconazole, voriconazole na posaconazole.