Advice
Following a full submission:
 
rivaroxaban (Xarelto®) is accepted for restricted use within NHS Scotland.
 
Indication under review:  the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation with one or more risk factors, such as congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, prior stroke or transient ischaemic attack.
 
SMC restriction: Rivaroxaban is accepted for use in patients who have poor INR control despite evidence that they are complying with a coumarin anticoagulant and in patients who are allergic to or unable to tolerate coumarin anticoagulants.
 
Rivaroxaban was non-inferior to standard oral anticoagulation at preventing stroke or systemic embolism in one large, double-blind study in patients with atrial fibrillation and moderate to high risk of stroke. This was not associated with a significantly increased risk of major or non-major clinically relevant bleeding.
 
The submitting company made an economic case for rivaroxaban use in the restricted patient population described above.

Download detailed advice194KB (PDF)

Download

Medicine details

Medicine name:
rivaroxaban (Xarelto) atrial
SMC ID:
756/12
Indication:
For atrial fibrillation
Pharmaceutical company
Bayer plc/Bayer Schering Pharma
BNF chapter
Cardiovascular system
Submission type
Full
Status
Restricted
Date advice published
13 February 2012