Are Meds Causing My Sleep Problems?

Monday, 07 Apr 2014 09:45 AM

By Peter Hibberd, M.D.

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Question: I am on 20 milligrams of Xarelto a day, but have been having trouble sleeping. Is the drug causing this problem, and should I take a sleeping pill to get to sleep?

Dr. Hibberd's answer:
 
Xarelto is taken by mouth usually at a dose of 20 milligrams daily. But sometimes lower doeses are recommended in cases of liver or kidney problems, or in certain circumstances.
 
Xarelto is an anticoagulant that does not usually require close monitoring to reduce the risk of stroke and blood clots in patients who have heart problems, deep vein thrombosis, a pulmonary embolism, or who require preventive management for clots after knee or hip surgery. It is not for use in pregnancy or if bleeding complications are evident. It does interact with other drugs and must be used with caution when drugs such as aspirin, NSAIDs such as Motrin or ibuprofen, among others.
 
The incidence of insomnia on Xarelto is actually very low, but it can be caused by its interaction with other drugs or taking too high of a dose. I recommend not taking one drug to treat the side effects of another, so would suggest you not take a sleeping pill. See your doctor for an alternative approach. For example, you might be able to take a lower dose (10 milligrams) twice a day. Eliminate all non-prescribed supplements and become educated on drugs to avoid using when on Xarelto.
 
If these approaches don't alleviate your insomnia, ask your doctor to help you determine whether your symptoms are related to the drug itself, or whether some other factor is involved here. Do not stop your Xarelto unless specifically instructed to do so by your personal treating physician. Sometimes the best choice is to transition to Coumadin or heparin therapy, and wean off the Xarelto.

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