On the 13th February 2012 The Scottish Medicines Consortium approved Rivaroxaban (Xarelto) for use in the prevention of stroke for patients with non-valvular atrial fibrillation and for the treatment of deep vein thrombosis and pulmonary embolism.

Rivaroxaban is accepted for restricted use within NHS Scotland for people with non-valvular atrial fibrillation who have poor INR control despite evidence that they are complying with a anticoagulant, and in patients who are allergic to or unable to tolerate anticoagulants.

Rivaroxaban has been shown to be non-inferior to standard low molecular weight heparin in combination with a vitamin K antagonist for the treatment of roximal DVT and prevention of recurrence. Experience with rivaroxaban in this indication for more than twelve months is limited, therfore the cost-effectiveness of indefinite treatment has not been demonstrated.

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