Xarelto side effects: dry skin and hair loss

Xarelto (Rivaroxaban) is an anticoagulant drug that recently raised many issues because of its severe adverse reactions. The most concerning ones are the internal hemorrhages that are frequently associated with this medicine. Although internal hemorrhage and harmful bleeding accidents are side effects associated with most blood thinners, Xarelto is different since there’s no antidote available to reverse its effects. For example, patients who suffered from gastrointestinal bleedings later died because of the complications.

Just like its Pradaxa (dabigatran) counterpart, a similar drug manufactured by Pfizer, Xarelto is also associated with other serious, and sometimes lethal side effects, such as an increased risk of blood clots, stroke, and liver damage. Nonetheless, even other common, albeit minor, adverse reactions associated with this drug can be annoying. Some of these include red or yellow eyes, fever, abdominal and joint pain, diarrhea, chills, abdominal and much more. All of them can be found on the drug’s label.

We searched around the web to find real people’s stories, including surveys and blog, seeking out for those secondary adverse reactions that the manufacturer never warned the public about. Two of them seem to be the most discomforting ones that plague many patients who take this medication: dry skin and hair loss. Hair loss is an unknown side effect of Xarelto caused by the reduction of blood reaching hair follicles, and it’s closely associated with dry skin. Microscopic hemorrhages under the skin caused by a lack of coagulation, may cause dermal cells’ death, making the skin become dry and fragile.

A correlation between hair loss and the use of Novel Anticoagulants (NOACs) has been found in two recent researches. In the first one, data from a large registry was evaluated by searching for newly reported cases of hair loss in 730 patients who were treated with rivaroxaban or dabigatran. Evidence showed that within 3 months since they started the therapy, 4.4% of patients suffered from hair loss.

Searching for stories on the famous medication website Drugs.com, we a found woman telling how she started losing her hair as soon as she began her treatment with the blood thinner. She was forced to wear a hair net to prevent her hairs from falling in the food she cooked. She explained that these precautions were necessary as her kids and husband kept finding her hair in the food she prepared. Another patient just above her comment talked about the fact he had no choice but to buy a new wig to replace the hair he lost.

Xarelto side effects include loosening, peeling or blistering of the skin, providing invaluable proof of how the anticoagulant power of this medication often goes out of control. Rivaroxaban was widely advertised as a convenient medicine. Unlike its competitor warfarin, it does not require continuous blood monitoring in specialized clinics. In a famous recent TV ad, the actor Kevin Nealon makes everyone laugh with a punchline: “Golf clinic or blood clinic? Ooh, that’s a tough one”. However, some of these “lesser” side effects should alarm the patients taking this medication that a more condition is (literally) happening  under his skin.

Another patient in a popular website about drugs complications explains that his skin started itching after just a week of treatment. He had to cover his body with shea butter daily since his skin became too dry. Several lawsuits have been filed against Xarelto manufacturing companies Johnson & Johnson (J&J) and Bayer Corp. (Bayer), accusing them of misleading advertisements.


1. Gelbricht V et al (2012) Hair loss is a potential side effect of novel oral anticoagulants—findings from the Dresden Noac Registry (NCT01588119). Blood 120:1173 (ASH Annual Meeting Abstracts)

2. Chrétien B, Besnard A, Sassier M, Le Hello C, Coquerel A, Alexandre J, Fedrizzi S. Rivaroxaban-induced hair loss. Eur J Clin Pharmacol. 2015, Aug 25.

3. Paul Harper, Laura Young, Eileen Merriman: “Bleeding Risk with Dabigatran in the Frail Elderly” N Engl J Med 2012; 366:864-866

4. Drugs.com – Question and Answers – “Does Xarelto cause hair loss?” 22 Jun 2013, www.drugs.com (Accessed September 2015)