Key takeaways

  • More common side effects of Xarelto include abdominal pain, muscle spasms, difficulty sleeping, fatigue (low energy), back pain, and bleeding.
  • If side effects from Xarelto become difficult to tolerate, talk with your doctor about coping tips or other treatment options.

Xarelto is taken to:

  • treat or prevent certain kinds of blood clots, such as deep vein thrombosis, in adults and some children in specific situations
  • decrease the risk of serious heart and blood vessel problems in certain adults

Keep reading to learn about the common, mild, and serious side effects (also called adverse effects) that Xarelto can cause. For a general overview of the drug, including details about its uses, see this article.

Xarelto has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Boxed warnings for Xarelto” section.

Xarelto can cause certain side effects, some more common than others. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult to tolerate.

Xarelto’s commonly reported side effects include:

For more information about some of these side effects, see “Tips for managing side effects.”

Examples of mild side effects that have been reported with Xarelto include:

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Xarelto unless your doctor recommends it.

Xarelto may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

For more information about some of these side effects, see “Tips for managing side effects.”

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Mild side effects are most common with Xarelto. But it’s possible to develop serious side effects from this medication. The following list may not include all possible serious side effects of the drug. For more information, you can refer to Xarelto’s prescribing information.

If you develop serious side effects while taking Xarelto, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported include:

  • bleeding, which may be serious or even life threatening
  • risk of blood clots after stopping Xarelto treatment too early (see “Boxed warnings for Xarelto”)
  • risk of blood building up around your brain or spine after certain spinal injections (see “Boxed warnings for Xarelto”)
  • changes in mood, such as anxiety or depression (see “Tips for managing side effects”)

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Xarelto and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Xarelto can cause an allergic reaction. This side effect wasn’t reported in studies, but it was reported after the drug became available on the market.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Xarelto treatment.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Xarelto, they may have you switch to a different treatment.

If you’re an older adult, you may wonder whether you’ll have different side effects from Xarelto than someone who’s younger.

In studies, most of the people taking Xarelto were ages 65 years and older. For the most part, side effects in older adults were the same as those in younger people. But older adults may have an increased risk of blood clots or bleeding from the drug compared with younger adults.

If you have any questions about the side effects of Xarelto in older adults, talk with your doctor or pharmacist.

In children, the most common side effects reported from Xarelto include:

Children may also have the same side effects as adults from taking this medication. For more information, see the “Mild side effects” and “Serious side effects” sections.

If you have questions about side effects that your child may develop due to Xarelto, talk with their doctor or a pharmacist.

Get answers to some frequently asked questions about Xarelto’s side effects.

Does Xarelto cause weight gain or weight loss?

No, Xarelto shouldn’t cause any changes to your body weight.

In studies of people taking Xarelto, weight gain and weight loss weren’t reported as side effects.

But it’s possible to lose weight from side effects that Xarelto causes. The drug can cause stomach infections, such as stomach flu or vomiting, which could affect body weight.

If you notice a change in your body weight during treatment with Xarelto, talk with your doctor. They can find out what may be causing your weight change and the best ways to treat or manage it.

Does the risk of Xarelto side effects vary based on the strength (such as 10-mg tablets vs. 20-mg tablets)?

It’s possible that you may have an increased risk of side effects when you take a higher dose of Xarelto. But this wasn’t reported in studies of the drug.

Xarelto comes as tablets in strengths of 2.5 milligrams (mg), 10 mg, 15 mg, and 20 mg. It also comes as a liquid suspension that has 1 mg of medication per milliliter (mL) of liquid.

If you take a higher strength of Xarelto, the amount of the drug in your body is higher. This may increase the risk of side effects.

If you’re having bothersome side effects from Xarelto, talk with your doctor. They can determine whether your dose of Xarelto needs adjusting.

For more information about Xarelto’s dosages, see this article.

Are hair loss or headaches side effects of Xarelto?

No, hair loss and headaches aren’t side effects that you should have from taking Xarelto. These weren’t reported in studies of the drug.

Other blood thinners, such as Jantoven (warfarin), may cause hair loss. But this doesn’t seem to be the case with Xarelto. If you have hair loss during Xarelto treatment, talk with your doctor about what may be causing it.

Headaches were also not reported in studies of Xarelto. But headaches may be a sign of bleeding, which is a side effect of the drug. In addition to headache, other symptoms of bleeding include:

If you have symptoms of bleeding, contact your doctor immediately or go to a hospital right away.

Does Xarelto cause thrombocytopenia (low platelet count)?

It’s possible that Xarelto may cause a low platelet count. This side effect wasn’t reported in studies of the drug. But it was reported after the drug became available on the market.

Symptoms of a low platelet count include:

If you notice symptoms of a low platelet count, tell your doctor. They can order a blood test to see whether your platelet levels are low and treat this condition if needed.

Could I experience liver problems from taking Xarelto?

It’s possible that Xarelto may cause liver problems. This side effect wasn’t reported in studies of Xarelto. But it was reported after the drug became available on the market.

Symptoms of liver problems include:

If you develop symptoms of liver problems, talk with your doctor. They can find out what might be causing the problem and discuss the best treatment.

Xarelto has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Risk of blood clots after stopping Xarelto treatment too early

Xarelto has a boxed warning for the risk of blood clots after stopping treatment too early. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

If you stop taking any blood thinner, including Xarelto, too early, you may increase your risk of blood clots. This can lead to serious or even life threatening reactions, such as a heart attack or stroke.

What might help

If you need to stop Xarelto treatment for any reason, be sure to talk with your doctor first. They can recommend another medication for your condition to help decrease your risk of blood clots.

Risk of blood building up around your brain or spine after certain spinal injections

Xarelto has a boxed warning for the risk of blood building up around your brain or spine after certain spinal injections. Boxed warnings are the most serious warnings from the FDA. They alert doctors and patients about drug effects that may be dangerous.

If you have a certain kind of spinal injection while taking Xarelto, your risk of blood building up around your brain or spine increases. Examples of spinal injections that might cause this side effect include spinal or epidural blocks and lumbar punctures.

A buildup of blood around your brain or spine can cause serious side effects, such as paralysis.

Symptoms of blood buildup around your brain or spine include:

What might help

If you need to have a spinal procedure during Xarelto treatment, tell your doctor. To prevent blood buildup around your brain or spine, they may recommend timing the procedure so you have the lowest amount of Xarelto in your body. This can decrease your risk of these side effects.

After the procedure, watch for the symptoms of blood buildup listed above. If you develop any of these symptoms, go to a hospital right away.

For more information about this side effect, talk with your doctor.

There may be things you can do to help make certain Xarelto side effects more manageable. If you have ongoing, worsening, or bothersome side effects, talk with your doctor or pharmacist. They can suggest tips for managing them or recommend other available treatment options for your condition.

Fatigue

It’s possible to develop fatigue (low energy) during your treatment with Xarelto. This side effect was common in studies of the drug.

What might help

Fatigue is usually mild and will go away over time. But if it’s severe or affects your daily activities, tell your doctor. They may recommend another treatment for your condition.

Back pain

It’s possible to develop back pain during treatment with Xarelto. But back pain wasn’t a common side effect reported in studies of Xarelto.

What might help

If you have back pain during your treatment, tell your doctor. It’s possible for back pain to be a sign of a more serious condition, such as blood buildup around your brain or spine. (Xarelto has a boxed warning for this side effect. To learn more, see the “Boxed warnings for Xarelto” section.) Your doctor will try to determine what is causing your back pain.

If Xarelto is causing your back pain, your doctor may recommend taking an over-the-counter pain medication to treat it. An example is Tylenol (acetaminophen).

Mental health problems, such as anxiety or depression

It’s possible to develop a mental health condition, such as anxiety or depression, from taking Xarelto. This was reported in studies of people taking the medication, though it was rare.

Symptoms of this side effect include:

  • losing interest in activities that used to excite you
  • feeling lonely or sad
  • feeling irritable
  • changes in sleep patterns, such as sleeping too much or too little

What might help

If you develop any symptoms of a mental health problem during your treatment with Xarelto, tell your doctor right away. They’ll be able to recommend ways to manage this side effect. Sometimes, they may suggest that you speak with another specialist, such as a psychiatrist.

If you have severe mental health problems, your doctor may recommend a different treatment option for you.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Consider the following important information before starting Xarelto.

Xarelto has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Boxed warnings for Xarelto” section.

Other precautions

Before taking Xarelto, discuss your health history with your doctor. Xarelto may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.