Xarelto (rivaroxaban tablets [generic for 2.5 mg tablet strength only] and oral suspension [generic]) — Cigna

Initial criteria

• Patient age ≥ 18 years
• Patient is taking concomitant aspirin ≥ 75 mg daily
• If rivaroxaban oral suspension (brand or generic product) is being requested, patient is unable to have Xarelto tablets appropriately administered

Approval duration

1 year