Xarelto now an approved medication for flight

March 12, 2012


Gary Crump

  • Director, AOPA Pilot Information Center Medical Certification Section
  • 28 years assisting AOPA members
  • Former Operating Room Technician, Professional Firefighter/Emergency Medical Technician
  • Pilot since 1973

Good news on the medication front: The FAA recently accepted Xarelto as an allowed anticoagulant for use in aviation. Xarelto (rivaroxaban) is a new type of anticoagulation drug that has a much more favorable side effect profile than its pharmaceutical cousin, Pradaxa (dabigatran) that produced disappointing side effects associated with uncontrollable bleeding in some patients who were using it.

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Xarelto is an oral anticoagulant that is used to treat and prevent blood clots (deep vein thrombosis) that can lead to a more serious condition known as pulmonary embolus. It is also prescribed to lower the risk of a blood clot in the presence of heart arrhythmias called atrial fibrillation; we expect to see many older pilots with atrial fibrillation being switched to Xarelto.

Other than the obvious benefit of being able to control bleeding, people using Xarelto will no longer have to track and monitor the INR (International Normalized Ratio) that measures the clotting characteristics of blood when using warfarin (Coumadin), a medication that has been in use for many years.

The FAA will want to see that you have been on Xarelto at least two weeks before submitting any medical records for consideration, and of course, the condition being treated must be stable. Because of the condition and the use of Xarelto, the FAA will certify pilots under special issuance authorizations with periodic status reports.

For more expert medical advice and professional assistance with protecting your pilot and medical certificates all year round, visit—and consider joining— AOPA Pilot Protection Services.

Gary Crump