# Effects of sleeve gastrectomy on rivaroxaban pharmacokinetics, efficacy, and safety

## TL;DR

This study examines how sleeve gastrectomy affects the body's processing and safety of the blood thinner rivaroxaban.

## Contribution

The study provides new evidence on the pharmacokinetics and safety of rivaroxaban after sleeve gastrectomy.

## Key findings

- Rivaroxaban pharmacokinetics remained stable before and after sleeve gastrectomy.
- No significant bleeding or thrombosis events occurred in patients taking rivaroxaban.
- Rivaroxaban 10 mg shows promise for VTE prophylaxis after bariatric surgery.

## Abstract

Thromboembolic events are potentially serious complications in patients undergoing bariatric surgery. Several studies have investigated the use of rivaroxaban in patients undergoing bariatric surgery. Further evidence is required to determine whether postsurgical anatomical and physiological changes affect the pharmacokinetics of rivaroxaban. This study aimed to investigate the pharmacokinetic, efficacy, and safety of rivaroxaban in patients who underwent sleeve gastrectomy surgery.

Included patients who admitted for sleeve gastrectomy surgery and were scheduled to receive prophylactic doses of rivaroxaban. Pre- and post-operative rivaroxaban plasma concentrations were determined. Efficacy and safety were assessed 6 and 9 months after surgery. Results: Twenty patients (40% males) were included in the study. The average body weight was 117.6 ± 21.2 kg. The average AUC values before, after, and 7-day after bariatric surgery were 5.83 (1.23), 5.34 (1.87), and 6.29 (2.12) μg·h mL−1, respectively. The average Cmax before, after, and 7-day after bariatric surgery were 0.45 (0.2), 0.37 (0.17), and 0.48 (0.23) μg mL−1, respectively. No significant differences were observed in the rivaroxaban PK parameters. No thrombosis events were reported over 6 or 9 months. In addition, 100% of the participants experienced no significant bleeding events or other adverse effects associated with rivaroxaban during the trial period.

Rivaroxaban 10 mg shows promise as a potential medication for VTE prophylaxis after bariatric surgery. However, future studies with larger, more diverse populations are needed to confirm these findings and strengthen their applicability in clinical practice and to determine the optimal dosage and long-term safety profile in this patient population.