Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation

NICE technology appraisal guidance [TA256] Published date:

NICE recommends rivaroxaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation (see below).

Who can have rivaroxaban?

You should be able to have rivaroxaban if you have atrial fibrillation without underlying heart valve disease and at least one of the following applies:

  • you have congestive heart failure (when the heart doesn’t pump blood as well as it should)
  • you have high blood pressure
  • you are 75 or older
  • you have diabetes
  • you have had a stroke or transient ischaemic attack (mini stroke) in the past.

Before starting treatment, your doctor should talk with you about the risks and benefits of rivaroxaban compared with another drug called warfarin. If you are already taking warfarin, you and your doctor should take into account how well your INR (international normalised ratio – a measure of how long it takes blood to clot) is controlled when deciding whether to switch to rivaroxaban.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE recommends rivaroxaban because its cost is justified by the benefits it provides compared with other treatments available on the NHS.

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