American Society of Hirudotherapy

Rivaroxaban

Oral Factor Xa inhibitor — FDA approved 2011. Conceptual descendant of antistasin/leech FXa research.

Studied off-labelLast updated: 2026-05-26 · Reviewed by ASH Editorial Board
Molecular weight of Rivaroxaban compared with other characterized leech-derived compoundsHementerin80 kDaHementin80 kDaHementin-Like Protein (HLP-1)80 kDaLeech Collagenase70 kDaHaemadipsa yanyuanensis Progr…70 kDaLeech Apyrase67 kDaCalin65 kDaHyaluronidase60 kDaAntithrombin III binding prot…58 kDaCollagenolytic Fibrinolysin55 kDaLeech Thrombospondin-Like Pro…50 kDaRivaroxaban0.4 kDa
Molecular weight (kilodaltons) of Rivaroxaban (highlighted) alongside other characterized leech salivary compounds. Smaller proteins/peptides generally diffuse and act faster.

Mechanistic Evidence Box

Studied off-label
Page type
Compound profile
Evidence type
Oral Factor Xa inhibitor — FDA approved 2011. Conceptual descendant of antistasin/leech FXa research.
Evidence level
FDA-cleared regulatory context
Drug vs leech
Synthetic analog
Safety domains
Bleeding

Clinical translation limit

Rivaroxaban is a chemically synthesized small-molecule Factor Xa inhibitor; it shares only the molecular target with leech antistasin and is not structurally derived from it. Its RCT evidence base (ROCKET AF) applies only to the drug, not to whole medicinal-leech therapy.

Molecular Profile

Category
Anticoagulant
Evidence tier
Tier A — FDA-approved derivative
Molecular weight
435.88 Da
Source species
Synthetic
Discovered
2008 · Bayer / Johnson & Johnson
PubChem CID
6433119
Derived FDA-approved drug
Xarelto (FDA approved July 2011)
Rivaroxaban molecular structure

Biological Targets

  • Factor Xa

Key Citations

  1. Patel MR et al. (ROCKET AF) (2011), N Engl J Med · PMID 21830957

Related Anticoagulant Compounds

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.