Patient/caregiver was educated on the precautions to be observed while taking xarelto as follows:

  1. Patients taking xarelto can present with nose bleeds at the slightest injury. Avoid excessive sneezing and nose picking, which can result in heavy nose bleeds. Also, avoid exposure to extreme cold climate, as the weather in cold seasons dry the mucus membrane out, thus damaging the integrity of nasal mucosa and resulting in nasal bleeds, that can be difficult to stop.
  2. Patients taking xarelto can present with easy gingival bleeding. Sometimes, the bleeding can be easily precipitated, even during brushing of the teeth. Use a toothbrush with soft bristles. Do not use a regular floss, as it injures the gums and results in swollen gums and intense bleed. Try using a waxed floss, instead of regular floss.
  3. Avoid drinking grapefruit juice, while you are taking xarelto. Grapefruit juice inhibits the metabolism of xarelto and this can lead to increased blood levels of xarelto for longer duration, leading to toxicity and episodes of bleeding.
  4. Take this medication as ordered by your physician. Xarelto can induce some nausea and vomiting, when taken on empty stomach. Taking the medication with some food or snack can help avoid these unpleasant gastrointestinal symptoms.