Medex: Advanced Anticoagulant Therapy for Superior Thrombosis Prevention
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Synonyms | |||
Medex represents the pinnacle of modern anticoagulation therapy, engineered to deliver precise thromboprophylaxis with enhanced safety parameters. This next-generation direct oral anticoagulant combines targeted factor Xa inhibition with optimized pharmacokinetics, establishing a new standard in stroke prevention and venous thromboembolism management. Developed through extensive clinical research and engineered for predictable therapeutic response, Medex offers healthcare professionals a sophisticated tool for managing thrombotic risk across diverse patient populations while minimizing traditional anticoagulation challenges.
Features
- Contains rivaroxaban as active pharmaceutical ingredient (20mg, 15mg, 10mg film-coated tablets)
- Selective direct factor Xa inhibition mechanism
- Rapid onset of action (2-4 hours to peak plasma concentration)
- High oral bioavailability (~80-100%) unaffected by food intake
- Dual elimination pathway (renal and hepatic)
- Predictable anticoagulant effect without routine coagulation monitoring
- Once-daily dosing regimen across indications
- Child-resistant blister packaging with Braille identification
Benefits
- Significantly reduces risk of stroke and systemic embolism in non-valvular atrial fibrillation patients
- Provides effective prevention and treatment of deep vein thrombosis and pulmonary embolism
- Demonstrates superior safety profile compared to warfarin with reduced major bleeding events
- Eliminates need for frequent INR monitoring and dietary restrictions
- Offers consistent anticoagulant effect with minimal drug-drug interactions
- Enables simplified treatment protocols that improve patient adherence and quality of life
Common use
Medex is indicated for multiple thrombotic conditions including stroke prevention in patients with non-valvular atrial fibrillation, treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), reduction in risk of recurrent DVT and PE, and prophylaxis of DVT following hip or knee replacement surgery. It is also used for extended thromboprophylaxis in medically ill patients at risk for thromboembolic complications. The medication is prescribed across various clinical settings including cardiology, hematology, vascular medicine, and postoperative care.
Dosage and direction
Dosage varies by indication: 20mg once daily with evening meal for stroke prevention in atrial fibrillation; 15mg twice daily with food for first 21 days followed by 20mg once daily for DVT/PE treatment; 10mg once daily for DVT prophylaxis following orthopedic surgery. Tablets should be swallowed whole with water and taken at the same time each day. For patients with renal impairment (CrCl 15-50 mL/min), dosage adjustment may be necessary. Avoid crushing or chewing tablets.
Precautions
Regular assessment of renal function is recommended, particularly in elderly patients or those with declining renal function. Use with caution in patients weighing less than 50kg or with conditions predisposing to bleeding. Monitor for signs of bleeding complications, especially during initial treatment period. Temporary discontinuation may be required before invasive procedures; consider timing based on procedure bleeding risk and patient renal function. Not recommended during pregnancy unless clearly needed.
Contraindications
Active pathological bleeding; severe hypersensitivity to rivaroxaban or any component; patients with prosthetic heart valves; significant hepatic disease associated with coagulopathy; concomitant use with strong CYP3A4 and P-glycoprotein inhibitors; severe renal impairment (CrCl <15 mL/min); pregnancy (third trimester) and breastfeeding.
Possible side effect
Common adverse reactions include bleeding complications (ranging from minor epistaxis to major hemorrhage), gastrointestinal symptoms (nausea, constipation), elevated liver enzymes, fatigue, and peripheral edema. Rare but serious side effects include spinal/epidural hematoma, anaphylactic reactions, and jaundice. Most bleeding events are minor, with major bleeding occurring in approximately 3% of patients annually.
Drug interaction
Strong CYP3A4 and P-glycoprotein inhibitors (ketoconazole, ritonavir) significantly increase rivaroxaban exposure and are contraindicated. Combined P-glycoprotein and CYP3A4 inducers (rifampin, carbamazepine) may decrease efficacy. Anticoagulants, antiplatelet agents, NSAIDs, and SSRIs may increase bleeding risk. Use caution with dronedarone, amiodarone, verapamil, and quinidine. No clinically significant interaction with digoxin or atenolol.
Missed dose
If a dose is missed, take it as soon as possible on the same day. For twice-daily dosing: take immediately and continue with regular schedule. For once-daily dosing: take when remembered unless next dose is due within 6 hours. Do not double dose to make up for missed dose. Maintain regular dosing schedule and consult healthcare provider if multiple doses are missed.
Overdose
Overdose may lead to hemorrhagic complications. No specific antidote exists; management includes discontinuation, symptomatic treatment, and supportive care. Activated charcoal may reduce absorption if administered within 8 hours of ingestion. In life-threatening bleeding, consider prothrombin complex concentrate, activated prothrombin complex concentrate, or recombinant factor VIIa. Dialysis not effective due to high protein binding. Monitor coagulation parameters and hemoglobin.
Storage
Store at room temperature (20-25°C/68-77°F) in original packaging protected from moisture. Keep blister strips sealed until time of administration. Do not transfer to other containers. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Protect from light and excessive heat.
Disclaimer
This information does not replace professional medical advice. Consult healthcare provider for proper diagnosis and treatment recommendations. Dosage and administration should be determined by qualified medical professionals based on individual patient characteristics. Report any adverse reactions to appropriate health authorities.
Reviews
Clinical trials demonstrate consistent efficacy with 21% relative risk reduction in stroke/systemic embolism compared to warfarin (ROCKET AF trial). Real-world evidence confirms favorable benefit-risk profile with 45% lower intracranial hemorrhage risk. Physicians report high patient satisfaction due to convenience and reduced monitoring requirements. Patients appreciate improved quality of life without dietary restrictions. Ongoing post-marketing surveillance continues to support positive risk-benefit assessment across diverse populations.