Rivaroxaban


Sunquest Code:RVXBAN  
Epic Code:LAB8193Epic Name:Rivaroxaban
Synonyms:Xarelto
Methodology:Chromogenic
Turnaround Time:Turnaround time is 4-8 hours if received during lab hours (see Associated Link).  With pre-notification, stats are done within 1 hour after receipt in the laboratory.
Special Instructions:See link to Specimen Collection and Processing for Coagulation Specimens
Testing should not be performed on patients receiving the reversal agent Andexxa.  This anti-Xa assay is not suitable for measuring reversal activity of Andexxa® due to high sample dilutions, which cause dissociation of the inhibitor from Andexxa.
Peak levels are drawn 2-4 hours post dosage.
Associated Links:

Specimen Collection and Processing for Coagulation Specimens



Collection Instructions

Specimen:Blood
Optimal Volume:2.7 mL (in 3 mL tube) - filled to fill line on the tube.
Minimum\Peds Volume:1.8 mL (in 2 mL tube) - filled to fill line on tube
Container:Blue Na Citrate, 3.2% - fill to fill line on tube
Collection Instructions:Peak levels are drawn 2-4 hours post dosage.

See link to Specimen Collection and Processing for Coagulation Specimens.
Causes for Rejection:Underfilled tubes, overfilled, clotted specimens or not received or processed and frozen within 4 hours of collection.


Processing and Shipping

Specimen Processing:See link to Specimen Collection and Processing for Coagulation Specimens.
Shipping Instructions:See link to Specimen Collection and Processing for Coagulation Specimens.
Stability:4 hours at room temperature
Test Performed at or Referral Lab Special Coagulation  (UMMC-East Bank)


Interpretive

Therapeutic Range:Therapeutic ranges have not been established for rivaroxaban. Target "on therapy" ranges are based on levels measured in subjects in clinical trials published in the literature. The on therapy range peak level measured 2-4 hours after taking the oral dose is approximately 184-343 nanogram/mL for 20 mg daily for stroke prevention in non-valvular atrial fibrilation and 189-419 nanogram/mL for 20 mg daily for acute treatment of deep venous thrombosis. {European Medicines Agency. Committee for Medicinal Products for Human Use. Assessment Report:Xarelto (rivaroxaban) EMA/42547/2012. September 22, 2011 Accessed December 6, 2019. Mueck et al. Clin Pharmacokinet 2011, 50:675-686; Mueck et al. Clin Pharmacokinet 2014;53:1-16]
Use:Rivaroxaban (Xarelto®) assay is an anti-Xa calibrated for rivaroxaban only.


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