ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Experimental Pharmacology and Drug Discovery
Effects of Sleeve Gastrectomy on Rivaroxaban Pharmacokinetics Parameters, Efficacy, and Safety
Provisionally accepted
Saeed Alqahtani1*
Anfal Almutairi1
Faten Aldajani1Manar Basudan1
Arwa Alzahrani1Maha Alenazi1
Emad Alsarhani1Abdulaziz Alsubaie1Alhassan Almaghrabi2
Fahad Bamehriz2Hamad Alsubaie2Farjah Algahtani2- 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- 2King Saud University, Riyadh, Saudi Arabia
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Background: 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. Methods: 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-days 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-days 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. Conclusions: 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.
Keywords: Anticoagulants, Bariatric Surgery, Pharmcokinetics, rivaroxaban, Thromboprophylaxis
Received: 12 Oct 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Alqahtani, Almutairi, Aldajani, Basudan, Alzahrani, Alenazi, Alsarhani, Alsubaie, Almaghrabi, Bamehriz, Alsubaie and Algahtani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Saeed Alqahtani
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