The FDA has approved Rivaroxaban (Xarelto) for stroke reduction in people with non-valvular atrial fibrillation, following a clinical trial with more than 14,000 patients comparing  it with the anti-clotting drug warfarin. In the trial,  Rivaroxaban was similar to warfarin in its ability to prevent stroke.

Rivaroxaba is an oral factor Xa inhibitor and like another new oral direct thrombin inhibitor (dabigatran) appears to rovide reliable anticoagulation treatment for the prevention of deep venous thrombosis and thromboembolism, as well as in the treatment of Acute Coronary Syndrome and Stroke prevention.

As with other anti-clotting drugs, Rivaroxaban can cause bleeding that, rarely, can lead to death. Bleeding was the most common adverse event reported by patients treated with Rivaroxaban in the major clinical trial for the prevention of stroke in non-valvular atrial fibrillation. In that trial, Rivaroxaban's risk of major bleeding was similar to that of warfarin; however, it caused less bleeding into the brain and more bleeding into the stomach and intestines.

Rivaroxaban offers once-daily dosing, without the need for routine blood monitoring.