Njenge-anticoagulant yomlomo entsha, i-rivaroxaban isetshenziswe kabanzi ekuvimbeleni nasekwelapheni isifo se-venous thromboembolic kanye nokuvimbela isifo sohlangothi ku-non-valvular atrial fibrillation. Ukuze usebenzise i-rivaroxaban ngokunengqondo, kufanele wazi okungenani lawa maphuzu ama-3.
I. Umehluko phakathi kwe-rivaroxaban namanye ama-anticoagulants omlomo Okwamanje, ama-anticoagulants omlomo asetshenziswa ngokuvamile ahlanganisa i-warfarin, i-dabigatran, i-rivaroxaban njalonjalo. Phakathi kwazo, i-dabigatran ne-rivaroxaban zibizwa ngokuthi ama-anticoagulants omlomo amasha (NOAC). I-Warfarin, ikakhulukazi isebenzisa umphumela wayo we-anticoagulant ngokuvimbela ukuhlanganiswa kwezici ze-coagulation II (i-prothrombin), i-VII, i-IX ne-X. I-Warfarin ayinawo umthelela ezicini ezihlanganisiwe ze-coagulation ngakho-ke inokuqala kancane kwesenzo. I-Dabigatran, ikakhulukazi ngokuvinjwa okuqondile komsebenzi we-thrombin (prothrombin IIa), inomphumela we-anticoagulant. I-Rivaroxaban, ikakhulukazi ngokuvimbela umsebenzi we-coagulation factor Xa, ngaleyo ndlela inciphisa ukukhiqizwa kwe-thrombin (i-coagulation factor IIa) ukuze ibe nomphumela we-anticoagulant, ayithinti umsebenzi we-thrombin esivele ikhiqizwa, ngakho-ke inomthelela omncane emsebenzini we-physiological hemostasis.
2. Izinkomba zomtholampilo zokulimala kwe-rivaroxaban vascular endothelial, ukugeleza kwegazi kancane, i-hypercoagulability yegazi nezinye izici zingabangela i-thrombosis. Kwezinye iziguli zamathambo, ukuhlinzwa kwe-hip noma idolo kuphumelela kakhulu, kodwa ngokuzumayo ziyafa lapho ziphuma embhedeni ezinsukwini ezimbalwa ngemva kokuhlinzwa. Lokhu kungenxa yokuthi isiguli saba ne-deep vein thrombosis ngemva kokuhlinzwa futhi safa ngenxa ye-pulmonary embolism ebangelwa i-thrombus ephumile. I-Rivaroxaban, ivunyelwe ukuthi isetshenziswe ezigulini ezikhulile eziqhutshwa ukuhlinzwa kwe-hip noma idolo ukuze kuvinjelwe i-venous thrombosis (VTE); kanye nokwelashwa kwe-deep vein thrombosis (DVT) kubantu abadala ukunciphisa ingozi yokuphindaphinda kwe-DVT kanye ne-pulmonary embolism (PE) ngemva kwe-DVT eyingozi. I-Atrial fibrillation iyi-arrhythmia yenhliziyo evamile evame ukufika ku-10% kubantu abangaphezu kweminyaka engu-75 ubudala. Iziguli ezine-atrial fibrillation zinokuthambekela kokuthi igazi limile ku-atria bese kwakheka amahlule, angaphuma futhi aholele ekushayweni. I-Rivaroxaban, ivunyelwe futhi inconyelwe iziguli ezindala ezine-non-valvular atrial fibrillation ukunciphisa ingozi yokushaywa yisifo sohlangothi kanye ne-systemic embolism. Ukusebenza kahle kwe-rivaroxaban akukhona okungaphansi kwe-warfarin, isigameko se-intracranial hemorrhage siphansi kune-warfarin, futhi ukuqapha okujwayelekile kokuqina kwe-anticoagulation akudingeki, njll.
3. Umphumela we-anticoagulant we-rivaroxaban uyabikezelwa, ngefasitela elibanzi lokwelapha, akukho ukuqoqwa ngemva kwemithamo eminingi, kanye nokusebenzisana okumbalwa nezidakamizwa nokudla, ngakho-ke ukuqapha okujwayelekile kwe-coagulation akudingekile. Ezimweni ezikhethekile, njengokusolwa ngokweqisa ngokweqile, izehlakalo zokopha okukhulu, ukuhlinzwa okuphuthumayo, ukuvela kwezigameko ze-thromboembolic noma okusolwa ukuthi akulandelwa kahle, ukunqunywa kwesikhathi se-prothrombin (PT) noma ukunqunywa komsebenzi we-anti-factor Xa kuyadingeka. Amathiphu: I-Rivaroxaban i-metabolized ikakhulukazi i-CYP3A4, okuyi-substrate ye-transporter protein P-glycoprotein (P-gp). Ngakho-ke, i-rivaroxaban akufanele isetshenziswe ngokuhambisana ne-itraconazole, i-voriconazole ne-posaconazole.