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3 Frequency of renal function assessment will vary based on a patient's risk for decline in renal function. When switching from warfarin to rivaroxaban, warfarin should be discontinued and rivaroxaban initiated when the INR is buy NU7441 be weighed against the urgency of intervention. Rivaroxaban should be restarted after the surgical or other procedures as soon as adequate hemostasis has been established. Oxygenase If oral medication cannot be taken after surgical intervention, administration of a parenteral anticoagulant should be considered.3 For thromboprophylaxis in AF, the recommended dose of rivaroxaban depends on a patient's renal function. Patients with a CrCl >50 mL/min should take 20 mg orally once daily with the evening meal, and patients with a CrCl 15 to 50 mL/min should take 15 mg orally once daily with the evening meal. Rivaroxaban should not be used in patients with a CrCl this website is no CrCl restriction.3 For treatment of DVT, PE, and reduction in recurrence of DVT and PE, rivaroxaban should be dosed at 15 mg BID for the first 21 days of treatment and at 20 mg once daily for the duration of therapy. Each dose should be taken with a meal. Studies of the cost-effectiveness of the use of rivaroxaban for post�Corthopedic surgery VTE prophylaxis are currently available in the literature. Decision-analytic models using the pooled results from the RECORD 1 and 2 trials showed that the use of rivaroxaban, compared with enoxaparin, provided a cost-savings of US $512 per patient and prevented 14 to 15 additional symptomatic VTE events per 100 patients during the year following THA. This investigation also found that rivaroxaban use was associated with a cost-savings of $466 per person and prevented 19 to 20 additional symptomatic VTE events per 1000 patients during the year following TKA. The cost-savings in the THA population seen with rivaroxaban treatment was due to the lower cost of rivaroxaban and the prevention of more symptomatic VTE events, whereas the cost-savings in the TKR population was due only to the lower cost of rivaroxaban (the investigators used estimated costs of $6.75 per day for rivaroxaban, $25.98 per day for enoxaparin 40 mg once daily, and $38.97 for enoxaparin 30 mg q12h; these cost estimates for enoxaparin were based on data obtained from an online drug-pricing database).