One of the drugs that belongs to the pharmacological group of anticoagulant drugs is Xarelto. This drug inhibits factor Xa, and it, in turn, is a component of the prothrombin activator and one of the components that ensure timely blood clotting (Xarelto analogues also have such properties).
To date, there have been many futile attempts to develop a drug that will have a similar effect and at the same time have a minimum of side effects. After numerous laborious efforts, a worthy analogue appeared - the drug "Pradaksa". This drug is the only substitute that can be fully used instead of Xarelto. Its characteristics are almost identical to the above, the only difference is the content of the active substance, which in both preparations is rivaroxaban.
Pharmacodynamics
All analogues of "Xarelto" have a similar effect. The only thing inthey differ - a quantitative and qualitative indicator of side effects. The only worthy analogue of this drug, which has a similar effect, is Pradaxa.
This drug and its Russian analogue "Xarelto" are direct highly selective drugs that slow down the action of factor Xa, that is, inhibit it. This drug has a high oral bioavailability, so the enteral route of administration is the main route for it.
The activation of factor X plays a central role in the coagulation cascade, followed by the biotransformation of factor Xa through the internal and external coagulation pathways.
Indications
As a rule, Xarelto analogues and the drug itself are used in the following situations:
- Prevention and prevention of stroke.
- Prevention and relief of systemic embolism.(In such cases, this drug is indicated for patients with atrial fibrillation, which is of non-valvular origin.)
- Elimination or prevention of blockage of deep veins by blood clots.
- Prevention of recurrence of pulmonary embolism.
Pradaxa, which is an analogue, is also indicated for the prevention of venous thromboembolic complications in patients who underwent surgery to replace one of the joints of the lower limb.
Contraindications
AnyoneThe Russian analogue of Xarelto has the following contraindications (they may differ, but only to a small extent):
- hypersensitivity or risk of allergic reactions to the substances contained in this medicinal product;
- active bleeding that has significant information content during clinical examination (for example, intracavitary bleeding or cerebral hemorrhage);
- situations in which there is an increased risk of volumetric bleeding, such as active ulcerative processes in the gastrointestinal tract;
- drug therapy with drugs that have similar properties - prevention of coagulation;
- when using non-fractional heparin at the dosage required for satisfactory catheter function;
- various liver diseases, the development of which can provoke bleeding of various etiologies;
- absolutely all analogues of "Xarelto" are contraindicated in patients with renal failure occurring in any phase;
- lactose intolerance, lack of galactose in the body;
- pregnancy and lactation;
- also for this drug and various analogues of "Xarelto" there is an age limit of 18+.
Category of people who can take this drug with care and under the supervision of a specialist
With caution and under the supervision of a doctor recommends using "Xarelto" instructions for use(analogues also) in the following cases:
- treating patients who have an increased risk of bleeding;
- Recently suffered peptic ulcer disease with a predisposition to recurrence;
- treatment of renal failure of varying degrees in combination with drugs that increase the level of rivaroxaban in the patient's body;
- patients who are being treated with drugs that can increase hemostasis;
- drugs that can increase rivaroxaban levels, such as azole antifungals;
- this drug and an analogue of Xarelto tablets are contraindicated in patients with HIV infection if they have recently taken various protease inhibitors of this virus.
Use during pregnancy and lactation
To date, it has not been precisely established how Xarelto, analogues of the drug, affect the effectiveness and safety of treatment in pregnant women.
Experiments that were conducted on animals in laboratories showed a pronounced toxicity of the active substance of this drug to the body of the expectant mother, since the drug leads to severe reproductive toxicity of the female body.
According to laboratory findings, the drug Xarelto, an analogue that is similar in pharmacological action, has the ability to cross the placenta, so this drug is contraindicated.
Also, during the period of using Xarelto, women should not forget abouteffective contraceptive measures, as conception, which accompanies the course of this drug, may adversely affect the intrauterine development of the fetus.
There are currently no objective judgments about how the use of this drug affects lactation, but laboratory studies on experimental animals suggest that the active substance - rivaroxaban - has the ability not to be metabolized and excreted in breast milk. Therefore, at the time of breastfeeding, it is worth refusing to use this drug.
Based on the data provided by laboratory studies, it can be said that rivaroxaban does not affect the ability of a sexually mature organism to create viable offspring in rats, but such experiments have not been carried out on humans.
Metabolism and elimination pathways
When taken enterally, there are three routes of elimination that correspond to a third of the total amount of unmetabolized drug:
- urinary excretion;
- excretion with feces;
- excretion by direct renal excretion (in this case, the substances are practically not metabolized and are excreted unchanged).
Rivaroxab is biotransformed through mechanisms independent of the cytochrome system.
The main metabolic pathways are the oxidation of the morpholine group and also the decomposition of amide bonds with water.
Test tube studies suggest thatrivaroxaban is the basis for P-glycoprotein and a protein that provides resistance to breast cancer.
As a rule, the excretion of metabolites is carried out for 5-9 hours.
Side effects
As the instruction for use says to the drug: analogues of Xarelto or the drug itself should be taken only as directed by a doctor. The instruction itself describes in detail the dosage of the drug or its analogues. Be sure to read the instructions before taking!
Below are all the undesirable processes and reactions that had the drug "Xarelto", analogues. The price of tablets is from 900 rubles. It's inexpensive considering most side effects are exceptions to the rule.
- Side effects seen with circulatory and lymphatic testing are anemia and thrombocythemia, which are rare.
- Tachycardia is the only side effect of this drug.
- Hemorrhages.
These are the contraindications to the drug "Xarelto" instructions.
Analogues of this drug can cause disorders in the digestive tract: bleeding, localized pain, dyspeptic manifestations, sometimes dry mouth.
Due to the administration of rivaroxaban, local reactions may occur: fever, swelling at the injection site with the parenteral route, weakness and malaise.
The occurrence of these processes is facilitated by the drug "Xarelto", analogues. The price of this drugas a rule, is standard for all pharmacy chains.
Methods of application and dosage
Detailed information on the correct intake can be provided by absolutely any instruction for the Xarelto preparation. The analogues of this drug in this respect do not differ fundamentally.
This drug is available in tablet form, so the pill is taken by the enteral route. If the patient for some reason cannot swallow the tablet, it can be crushed and mixed with a suitable liquid (tea, water).
Food should be followed immediately after taking this drug.
Overdose
If the dose of Xarelto is not observed, an overdose is possible, which, as a rule, is treated symptomatically, since this drug does not have a specific antidote.
In order to reduce the absorption of this drug in the small intestine, you can use any sorbent, such as activated charcoal. Also, for the speedy removal of metabolites, it is necessary to provide forced diuresis, which is carried out by drinking a large amount of fluid and using diuretics.
Prices
Depending on the manufacturer, the price of Xarelto ranges from 899.00 rubles. for 10 tablets containing 10 mg of the active ingredient, up to 1740, 49 rubles
A pack of 30 tablets can be purchased for 3300.00 rubles
The largest package contains 100 capsules, its cost is 8600 rubles
PricePradaxa drug policy depends on the quantitative content of the active substance in one capsule:
- 75 mg - RUB 716.00;
- 110 mg - 1574.00 RUB;
- 150 mg - RUB 1676.00
