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Mixing Xarelto & Alcohol

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Xarelto, or Rivaroxaban, is a blood thinner prescribed to help prevent strokes and blood clots. It may be used in conjunction with aspirin to reduce the risk of heart problems for those with chronic coronary artery disease. If you are currently taking Xarelto and consuming alcohol, you may want to learn more about the substances’ risks and side effects. In this article, we will discuss more about Xarelto, the side effects of mixing alcohol and blood thinners, and how you can seek treatment if you struggle to limit your alcohol use.

Are you worried about how your alcohol use has been impacting your health? Guardian Recovery can help. We offer individualized treatment for alcohol-use disorder designed to treat all aspects of your physical and mental wellness. When you call, you will be connected with a Treatment Advisor who will answer any questions you may have. Choosing to seek treatment is a significant decision, and Guardian Recovery is here to provide you with guidance every step of the way. Contact us to learn more about our substance use treatment programs, medically-supervised detox, addiction therapy, and insurance programs or to schedule a pre-admission assessment. Our goal is to provide premier quality care to clients and their families. We genuinely care about your future and want to see you begin your journey toward wellness.

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Alcohol & Xarelto

According to the Agency for Healthcare Research and Quality (AHRQ), more than 2 million people take blood thinner medication daily to prevent blood clots from forming. Additionally, alcohol is not only a common substance used, but drinking in excess is becoming an emerging trend. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 85.6% of Americans have used alcohol, and 25.8% of adults 18 and older engaged in binge drinking in the past month. It is reported that people who binge alcohol were 70-93 times more likely to experience an alcohol-related emergency department visit. This risk is even greater if substances such as Xarelto are combined with alcohol. This is a dangerous combination without fully understanding a common drug’s side effects and risks.

What Is Xarelto?

Xarelto, or Rivaroxaban, is a blood thinner prescribed to reduce the risk of heart attack and stroke. Because the medicine causes the blood to be thinner, it flows through veins more quickly and is less likely to form clots which cause a heart attack, stroke, or pulmonary embolism. People with irregular heartbeat, recent hip or knee surgery, or coronary heart disease are more at risk of developing blood clots. The most common side effect of Xarelto is bleeding more than normal. This includes frequent nose bleeds, heavier menstrual cycles, bleeding gums, and bruising.

Common Side Effects of Xarelto:

  • Bleeding more than usual.
  • Tiredness.
  • Lack of energy.
  • Paler skin.
  • Heart palpitations.
  • Feeling dizzy.
  • Skin rash.
  • Nausea or vomiting.

Serious Side Effects of Xarelto:

  • Severe bleeding that doesn’t stop after 10 minutes.
  • Red or black stool.
  • Bruising that is growing in size.

It is important to seek immediate emergency medical assistance if you notice any serious side effects.

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Side Effects of Mixing Xarelto & Alcohol

Because alcohol is also a blood thinner, drinking excessive amounts of alcohol and taking a blood thinner such as Xarelto can be a dangerous combination. The following side effects should be understood, and alcohol use should be discussed thoroughly with your doctor before beginning Xarelto.

In addition to the effects alcohol has on thinning the blood, specific individuals should proceed with caution before combining alcohol and Xarelto. If you have a problem with your liver or kidneys, these organs will impact how they metabolize the blood thinner. If the blood becomes too thin, it will put a person at serious risk for life-threatening complications.

Signs of Serious Bleeding From Alcohol & Xarelto:

  • Blood in urine or stool.
  • Coughing up blood.
  • Bleeding that doesn’t stop after 10 minutes.
  • Abnormal bruising that grows in size.
  • Severe headaches.

Seek immediate medical attention if you notice any of these symptoms.

Increased Risk of Internal Bleeding

Alcohol is known as a blood thinner. When you are taking substances to thin your blood, it is less likely to thicken, which makes it more difficult for blood clots to form. Blood thinners can be dangerous because of an increased risk of severe bleeding during an accident or injury.

Additionally, when using alcohol and Xarelto, one is at a greater likelihood of experiencing internal bleeding. Excessive alcohol use can cause peptic ulcers, leading to pain, irritation, and bleeding.

One study concluded that a person who drank more than 5 drinks each day had 6.3 times more significant risk of gastrointestinal bleeding.

Signs of possible gastrointestinal bleeding include black tarry stool, bright red blood in vomit, cramps in abdomen, dark or bright red in stool, dizziness, tiredness, shortness of breath, and vomit that looks like coffee grounds

You should seek medical attention immediately if you notice any of these symptoms. Although gastrointestinal bleeding is treatable if detected early, it can lead to severe complications and is life-threatening if ignored.

Increased Risk of Liver Damage

It is already well known that alcohol use can damage the liver over time. Combining both substances to excess increases the risk of liver damage and chronic liver disease if not treated.

Why do these substances impact the liver? Because it is the liver’s job to flush out toxins before entering the bloodstream. When we chronically use alcohol and other substances like Xarelto, we put the liver in overdrive by trying to clean out the additional toxins from our system.

This overuse of the liver leads to damage and possible disease if long-term issues continue over time.

There are signs and symptoms to look for possible liver damage or disease. The sooner you can diagnose liver damage, the more quickly you can receive treatment and have a better chance of recovering.

Common Signs of Liver Damage:

  • Significant fatigue and exhaustion.
  • Unexplained weight loss and lack of appetite.
  • Nausea and vomiting.
  • Pain in the upper right side of the abdomen.

Reversing liver damage is not always possible; however, if you notice signs of potential liver damage, there may be ways to reduce the symptoms if you seek treatment early. According to the American Liver Foundation, abstaining from alcohol is the most effective approach to reversing or reducing liver disease progression.

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Please contact us today if you are concerned about your health due to alcohol-use dependence. You don’t have to wait for your health to decline to prioritize your wellness. Focusing on recovery can improve health, repair relationships, and change your life.

Guardian Recovery will be able to complete a thorough evaluation to assess the treatment program right for you. In addition to a free telephone assessment to evaluate your individual treatment needs, we also can provide a no-obligation insurance benefits check at your convenience.

We work with most major health insurance providers, ensuring our programs remain as accessible as possible to those who need them. However, we will help you explore alternatives, such as self-pay and private pay, if you are uninsured or underinsured.

It can be frightening to reach out for help, and our goal is to ensure our streamlined process is stress-free from beginning to end. Contact us today to begin your new life in recovery.


How much alcohol can you safely drink while taking Xarelto?

A: It should be fine to consume alcohol occasionally. However, no more than 1-2 drinks per week.

Can you drink alcohol while taking blood thinners?

A: Mixing alcohol and blood thinners are never recommended. The risks of severe bleeding during an accident or injury are higher when drinking alcohol and taking blood thinners.

Does alcohol make blood clots or the risk of stroke worse?

A: Liver damage from excessive alcohol use can prevent blood from clotting and increase the chances of a stroke.

Is Xarelto hard on the liver?

A: Xarelto has been known to cause liver damage, specifically for men over 60 who have been on this specific medication for over 6 months or more.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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