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.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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