Rivaroxaban 20 mg: uses, price & cheaper substitutes
Prescription required (Schedule H)
Common uses: Preventing stroke and clots in atrial fibrillation (irregular heartbeat); Treating blood clots in the legs (DVT) and lungs (pulmonary embolism) and preventing them from coming back.
Listed MRPs range from ₹10.04 to ₹73.39 per tablet across 9 listings. Use only on a doctor's prescription.
Price comparison
| Brand | Manufacturer | Pack | MRP | ₹ / tablet | As on |
|---|---|---|---|---|---|
| Rivaroxaban Tablets 20mgJan Aushadhi | Jan Aushadhi (PMBJP) | 14 | ₹140.63 | ₹10.04 | 19 October 2026 |
| Rpigat 20 | Natco Pharma Ltd | 10 | ₹131.25 | ₹13.12 | 19 October 2026 |
| Ricosprin 20 | USV Private Limited | 15 | ₹367.20 | ₹24.48 | 19 October 2026 |
| Rivaban 20 | Lupin Ltd | 10 | ₹246.65 | ₹24.66 | 19 October 2026 |
| Rivaflo 20 | Sun Pharmaceutical Industries Ltd | 10 | ₹366.00 | ₹36.60 | 19 October 2026 |
| Rivaxa 20 | Abbott | 15 | ₹555.82 | ₹37.05 | 19 October 2026 |
| Rovor 20 | Torrent Pharmaceuticals Ltd | 10 | ₹375.98 | ₹37.60 | 19 October 2026 |
| Rivared 20 | Dr Reddy's Laboratories Ltd | 10 | ₹478.36 | ₹47.84 | 19 October 2026 |
| Xarelto 20 | Bayer Zydus Pharma Pvt Ltd | 14 | ₹1027.50 | ₹73.39 | 19 October 2026 |
MRPs as printed/listed on the date shown; actual price may vary.
Uses
- Preventing stroke and clots in atrial fibrillation (irregular heartbeat).
- Treating blood clots in the legs (DVT) and lungs (pulmonary embolism) and preventing them from coming back.
- Preventing clots after hip or knee replacement surgery (lower strength).
- Reducing heart attack and stroke risk in coronary or peripheral artery disease (low dose with aspirin).
How to take it
Take one 20 mg tablet once a day with food – the 15 mg and 20 mg strengths are absorbed properly only when taken with a meal, so take it with your main meal at the same time each day. Swallow with water; if you cannot swallow it whole it can be crushed and mixed with water or apple puree and taken immediately with food. For a fresh clot, a higher twice-daily dose is used for the first three weeks before switching to 20 mg once daily. No INR tests are needed, but do not miss doses. Do not stop unless your doctor tells you to; stopping suddenly raises stroke and clot risk. Carry your anticoagulant card and tell every doctor and dentist.
Side effects
Common
- Bleeding more easily – nosebleeds, bleeding gums, bruising, heavier periods.
- Anaemia (tiredness, pale skin).
- Nausea, stomach pain or indigestion.
- Dizziness or low blood pressure on standing.
- Itchy skin or limb swelling.
Serious
Stop and get medical help urgently if you notice any of these.
- Heavy or internal bleeding – blood in urine or stools, black stools, vomiting or coughing blood – go to hospital.
- Sudden severe headache, confusion, weakness or slurred speech (possible brain bleed) – emergency.
- Serious allergic reaction – swelling of the throat or tongue, difficulty breathing.
- Any head injury – get checked even if you feel fine.
Safety information
Alcohol
Keep alcohol moderate. Heavy drinking raises bleeding risk and can cause falls.
Pregnancy
Not used in pregnancy or breastfeeding. Use reliable contraception while taking it and tell your doctor if you are pregnant or planning to be.
Kidney problems
The dose is reduced to 15 mg if kidney function is moderately reduced and it is avoided in severe kidney failure. Your doctor checks creatinine regularly.
Liver problems
Not suitable if you have liver disease with bleeding risk; tell your doctor about any liver problem.
Children
Used in children only under a specialist with weight-based dosing.
Missed dose
If you take it once a day and remember the same day, take it with food straight away; if it is the next day, skip it. Never take two doses together.
Interactions
- Painkillers like aspirin, ibuprofen, diclofenac (NSAIDs) – higher bleeding risk; use paracetamol.
- Other blood thinners – warfarin, clopidogrel, heparin – only when your doctor plans the combination.
- Antifungals ketoconazole and itraconazole, and HIV medicines such as ritonavir – raise rivaroxaban levels; avoided.
- Rifampicin, carbamazepine, phenytoin and St John's wort – lower rivaroxaban levels and reduce protection.
- SSRI antidepressants (sertraline, escitalopram) – slightly higher bleeding risk.
- Some heart rhythm medicines such as dronedarone – tell your cardiologist.
Frequently asked questions
What is Xarelto 20 used for?
Xarelto 20 is rivaroxaban 20 mg, a once-daily oral blood thinner. It prevents stroke in atrial fibrillation and treats or prevents clots in the legs and lungs.
Why must Xarelto 20 be taken with food?
At the 15 mg and 20 mg strengths, rivaroxaban is absorbed much better with a meal. Taking it on an empty stomach can leave you under-protected. Take it with your biggest meal of the day.
Xarelto 10 vs Xarelto 20 – what is the difference?
20 mg once daily is the standard dose for atrial fibrillation and long-term clot treatment. 10 mg is used after joint replacement and for extended prevention after a clot, and can be taken without food. Your doctor decides.
Does rivaroxaban need INR tests?
No. Its effect is predictable, so routine INR monitoring is not required. Your doctor will still check kidney function and blood counts periodically.
Can I take Xarelto 20 with alcohol?
Keep alcohol moderate. Heavy drinking increases bleeding risk and the chance of falls.
Rivaroxaban vs apixaban – which is better?
Both are similar newer anticoagulants. Rivaroxaban is once daily (with food); apixaban is twice daily and may have a slightly lower bleeding risk in some studies. Your cardiologist chooses based on your kidneys, age and how easily you remember doses.
Can I take Ecosprin or Combiflam with Rpigat 20?
Low-dose aspirin only if a cardiologist specifically prescribes it. Avoid Combiflam, ibuprofen and other NSAIDs; paracetamol is the safe painkiller.
Do I need to stop Xarelto before surgery or a tooth extraction?
Tell the surgeon or dentist in advance. It is usually paused 24 to 48 hours before a procedure with bleeding risk; minor dental work may not need a pause. Never stop it on your own.
Is Rpigat 20 the same as Xarelto?
Yes. Rpigat, Rivaflo, Rivaban and other Indian brands contain the same rivaroxaban 20 mg. Confirm with your doctor before switching brands.
Sources
- NHS – Rivaroxaban (19 October 2026)
- NPPA Pharma Sahi Daam (ceiling prices) (19 October 2026)
- PMBI Jan Aushadhi Product & MRP List (19 October 2026)
Medyzen Editorial Team · Last updated
This page is general information, not medical advice. Do not start, stop or change a medicine without asking a doctor or pharmacist. Terms