Xarelto And Caffeine

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Eric Says:

I have found that I am more tired than usual and can/need sleep for extended periods since I have started Xarelto. I attempted to take caffeine pills in the morning to help me wake up only to notice after taking the caffeine pills I begun to have bleeding during bowel movements. When I stop taking the caffeine pills the bleeding really subsides to nearly non-existent.

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David Says:

Hi Eric,

Sorry to hear about your recent experience with bleeding during bowel movements. From what I could gather, there don't appear to be any interactions listed between caffeine and Xarelto (rivaroxaban). However, you might be surprised to know that Xarelto does actually list "bloody stools" as one of its more common side effects at:


It even seems to list other side effects related to bleeding as well. So that does make me wonder if the caffeine has anyway of triggering the onset of this side effect even though there aren't interactions listed online. Maybe the way your body responds to caffeine indirectly makes it respond differently to Xarelto as well?

Have you talked with your doctor about this concern at all?

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Eric Says:

No my doctor was more concerned with how often I bled. Again, once I stopped the caffeine pills, the bleeding just about stopped completely. I was amazed. I guess I left out a ton of specifics too. I am a male. I'm 48 but VERY athletic. I work out, swim, I'm on the tennis team for my n'hood and I run daily. I had a blood clot form on a flight for work and had a very small stroke that took me 3 months to recover from. It has been 1 year since the stroke. I was put on Xarelto b/c my Thrombin/Anti Thrombin ratio was 7 instead of the 3 it's supposed to be. My vision is still not quite what it was. On the morning of the stroke I woke up and my dominant eye saw straight and my non-dominant eye was "stuck" on my nose. Oh, and EVERYTHING pulled to the right making it difficult to walk. I had a very difficult time waking up and was EXTREMELY exhausted for 3 months following. I'm almost back to "normal" and have resumed all exercise activities but my vision is still just not quite there and when I get stressed or very upset I get a back headache on the top of my head.

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David Says:


Glad to hear that you're able to start feeling "normal" once again. From what I've read online, depending on the severity of a stroke, that can actually cause headaches as well as blurred/double/or loss of vision in either eye. Although I image it could also cause other vision-related restraints similar to what you described as well. So I really do hope you continue to notice improvements overtime as things heal.

I am still curious to know about the role caffeine plays in this situation, being that it affects your bleeding. But I believe there are other herbs like ginseng that also provide a nice energy boost if you're doctor says it's ok to take as an alternative to caffeine.

Hope this helps!

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GD Says:

David -

Nice to see someone else who is athletic and still got a blood clot (Obviously clots are not good)! I'm a college basketball player and (after knee surgery) got a DVT in my femoral vein that broke off and showered over both my lungs. I was on xarelto for 3 months and had similar problems with caffeine and bleeding during bowel movements. Caffeine actually gave me chest pains as well (even when I stopped xarelto which was a couple weeks ago). I suggest moving from coffee to tea! That's helped me with both the bleeding and chest pains... might not have as much caffeine but it has some :)

Hope you've been able to participate in all your activity!

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Anthony Says:
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Hi I've just started xarelto last couple of weeks and the chest pain is unreal plus i like coffee could the two together be making chest pain worse

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Nicole Says:
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I started xarelto 10 days ago and have blood clots in my lung again. I also had a drink of iced coffee and I can immediately feel caffeine jitters. I used to drink coffee all day, but not now. Is this drug the cause?

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