Table of ContentsView AllTable of ContentsWhat Is Xarelto?What Is Eliquis?DosingEfficacyAlternative Treatment OptionsSide EffectsPrecautionsInteractionsStaying Safe on Blood ThinnersFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Xarelto?
What Is Eliquis?
Dosing
Efficacy
Alternative Treatment Options
Side Effects
Precautions
Interactions
Staying Safe on Blood Thinners
Frequently Asked Questions
Your healthcare provider may recommend usinganticoagulant medications (blood-thinning medications)to treat or prevent blood clots.
Blood-thinning drugs can treat or preventdeep vein thrombosis (DVT, a blood clot, usually in the leg)andpulmonary embolism (PE, a blood clot in the lung), among other conditions stemming from blood clots, in adults.
Blood thinners are a crucial form of medication in the United States. To date, more than half of all Americans 18 and older take one or more blood thinners.
Notable options include Xarelto (rivaroxaban) and Eliquis (apixaban), two prescription-based, orally administered medications that are categorized as factor Xa inhibitors (drugs that keep your blood from clotting too much).
These Food and Drug Administration (FDA)–approved prescription drugs are used to prevent and treat various blood clots.
Although both medicines are in the same drug class, they share some distinct differences that potential users should be aware of. Read on for an in-depth analysis of Xarelto vs. Eliquis.
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The following will outline the purposes for which Xarelto is used, alongside an explanation of how the drug works within the body to create its desired effects.
Approved & Off-Label Uses
Xarelto is FDA-approved for the following conditions in adults:
Xarelto is FDA-approved for the following conditions in children and adolescents:
Sometimes, healthcare providers prescribe an approved drug for a condition or in a manner that is not FDA-approved. This is called off-label prescribing.
Healthcare providers sometimes prescribe Xarelto off-label to prevent blood clots after percutaneous coronary intervention (PCI, previously known asangioplastywith a stent).
Angioplasty involves opening up blocked or narrowed blood vessels in the heart in people with nonvalvular AFib.
How Does Xarelto Work?
Xarelto is a direct-acting oral anticoagulant (DOAC) or a factor Xa inhibitor.Standard blood thinners, such as Jantoven (warfarin), require blood tests and dietary restrictions and carry a risk of uncontrolled bleeding.
In comparison, DOACs are highly effective and don’t require regular blood testing or special diets.
The following will outline the purposes for which Eliquis is used, alongside an explanation of how the drug works within the body to create its desired effects.
Eliquis is FDA-approved for the following conditions in adults only:
Healthcare providers sometimes prescribe Eliquis off-label for the following uses:
How does Eliquis Work?
Like Xarelto, Eliquis is an oral anticoagulant—also called a DOAC or a factor Xa inhibitor.
Dosing Comparison
The following information provides general guidelines for Xarelto and Eliquis dosing in adults.
Your healthcare provider will give you directions on taking Xarelto and Eliquis, including how long you should take the medication and any other considerations.
Xarelto
The following dosages are for adults with normal kidney function. Those with kidney problems may need a lower dosage or will need to avoid using Xarelto. For children, the dosage depends on their age and weight.
Standard dosing regimens for Xarelto are as follows:
Eliquis
The following dosages are for adults with normal kidney function. Those with kidney problems may need a lower dosage or will need to avoid using Eliquis.
Standard dosing regimens for Eliquis are as follows:
Comparative Efficacy
It’s important to note that both drugs have undergone clinical trials to ensure they are effective and safe. Still, only your healthcare provider can determine which medication is more appropriate for you based on individual factors. We can provide some general information on studies and what has been found.
A meta-analysis (combining results from two or more separate studies) of over 24,000 individuals found that Xarelto and Eliquis had similar efficacy in preventing blood clots but that people who took Eliquis had fewer bleeding episodes.
Another study compared Eliquis, Xarelto, Pradaxa (dabigatran), and Jantoven. The researchers found Eliquis to be the most favorable in terms of efficacy and safety.
A study published in theAnnals of Internal Medicinefound that those who took Xarelto had more bleeding and slightly more incidences of clotting than Eliquis.
One study published in theJournal of the American Medical Association(JAMA) found that in older adults (65 and older), people who took Xarelto had more incidences of bleeding and clotting than those who took Eliquis.
The National Blood Clot Alliance (NBCA) recommends the following in addition to taking your prescribed medication:
Determine if you are at risk of blood clots risk and inform your healthcare provider. Your family and medical history, including recent surgeries, may indicate whether you could experience blood clots.
Recognize the signs and symptoms of blood clots. The National Blood Clot Alliance uses the slogan “STOP the CLOT,” in which each letter indicates a symptom.
“STOP” stands for swollen legs, tenderness in the legs, shortness of breath, and passing out (feeling lightheaded). “CLOT” stands for chest pain, leg discoloration, overdrive (feeling like the heart is racing), and time (to call 911).
Tell your healthcare provider if you have any risk factors for blood clots, especially before any surgery. If you have any blood clot symptoms, get medical attention immediately.
If you are resting in a hospital or home, ask your healthcare provider about the best ways to prevent blood clots. When traveling on a plane, a train, or in a car, take a break at least every two or three hours so you can get up, walk around, and stretch your legs.
Maintain ahealthy weight. Consult a registered dietitian to help you design an eating and exercise plan that fits your lifestyle.
Finally, do not smoke orvape. If you do, ask your healthcare provider forrecommendations on how to stop.
Side Effects & Safety
Like all drugs, Xarelto and Eliquis carry the potential for side effects.
Be aware of these side effects and consult a healthcare provider if you experience symptoms that worsen or fail to stop.
The warning states the following:
Common Side Effects
Bleeding is the most common side effect of Xarelto and Eliquis, ranging from mild to life-threatening.
Other common side effects of Xarelto in adults includeback pain,stomach pain, anddizziness. In comparison, common Xarelto side effects in children include cough, vomiting, and fatigue.
Conversely, other common side effects of Eliquis includeanemiaand nausea.
Severe Side Effects
Serious side effects may occur as a result of using Xarelto or Eliquis. Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening, or you think you have a medical emergency.
Serious side effects and their symptoms can include the following:
This is not a complete list of side effects, and others may occur. Call your healthcare provider if you have unusual problems while taking this medication.
Before taking Xarelto or Eliquis, tell your healthcare provider about your medical conditions, medical history, and family history.
Always ask your healthcare provider for advice if you are pregnant or breastfeeding.
You should not take Xarelto or Eliquis if you are allergic to any ingredient in the medication or if you are actively bleeding.
Xarelto and Eliquis are also contraindicated (should not be used) in people:
Potential Adverse Interactions
Tell your healthcare provider about all your medicines, including prescription, over-the-counter (OTC), and vitamins or supplements.
While taking Xarelto or Eliquis, do not start any new medications without approval from your healthcare provider.
Some examples of drug interactions include:
This is not a complete list of drug interactions. Other drug interactions may occur with Xarelto or Eliquis.
Consult your healthcare provider for more information about drug interactions and how they may affect you.
While taking a blood thinner, be alert to signs and symptoms of bleeding, such as:
Some tips for staying safe while taking a blood thinner include:
Summary
Xarelto and Eliquis are orally administered prescription blood thinners to prevent and treat blood clots. These drugs are considered safe, reliable, and vital in preventing DVT and PE.
While Xarelto and Eliquis are in the same class of drugs, they share some key differences, including their active ingredients, specific uses, and dosing guidelines.
Consult with your healthcare provider for more information about these medications and guidance on which drug is best for you.
Frequently Asked QuestionsStore Xarelto or Eliquis at room temperature (between 68 and 77 degrees F), away from direct light, heat, and moisture. Do not store it in the bathroom. Keep out of the sight and reach of children and pets.Because both drugs are only available in brand name, the out-of-pocket prices can be costly. However, most insurance covers these medications. Your co-pay or coinsurance will depend on your plan.You can contact your insurance plan and ask for the most recent pricing information on Eliquis or Xarelto.
Store Xarelto or Eliquis at room temperature (between 68 and 77 degrees F), away from direct light, heat, and moisture. Do not store it in the bathroom. Keep out of the sight and reach of children and pets.
Because both drugs are only available in brand name, the out-of-pocket prices can be costly. However, most insurance covers these medications. Your co-pay or coinsurance will depend on your plan.You can contact your insurance plan and ask for the most recent pricing information on Eliquis or Xarelto.
Because both drugs are only available in brand name, the out-of-pocket prices can be costly. However, most insurance covers these medications. Your co-pay or coinsurance will depend on your plan.
You can contact your insurance plan and ask for the most recent pricing information on Eliquis or Xarelto.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Blood thinners.National Blood Clot Alliance.Majority (55 percent) of Americans taking blood thinners indicate they fear suffering from major bleeding; 73 percent more cautious with routine activities to avoid risk.MedlinePlus.Apixaban.MedlinePlus.Rivaroxaban.DailyMed,Label: Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban kit Xarelto- rivaroxaban granule, for suspension.Chen A, Stecker E, Warden BA.Direct oral anticoagulant use: a practical guide to common clinical challenges.Am Heart Assoc. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559DailyMed.Label: Eliquis- apixaban tablet, film coated.Aryal MR, Gosain R, Donato A, et al.Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world.Blood Adv. 2019;3(15):2381-2387. doi:10.1182/bloodadvances.2019000572Hernandez I, Zhang Y, Saba S.Comparison of the effectiveness and safety of apixaban, dabigatran, rivaroxaban, and warfarin in newly diagnosed atrial fibrillation.Am J Cardiol. 2017;120(10):1813-1819. doi:10.1016/j.amjcard.2017.07.092Fralick M, Colacci M, Schneeweiss S, et al.Effectiveness and safety of apixaban compared With rivaroxaban for patients with atrial fibrillation in routine practice: a cohort study.Ann Intern Med. 2020: doi:10.7326/M19-2522Ray WA, Chung CP, Stein CM, et al.Association of rivaroxaban vs apixaban with major ischemic or hemorrhagic events in patients with atrial fibrillation [published correction appears in JAMA. 2022(13):1294.JAMA. 2021;326(23):2395-2404. doi:10.1001/jama.2021.21222National Blood Clot Alliance.Prevent blood clots.National Blood Clot Alliance.Know your risk.National Blood Clot Alliance.Signs and symptoms of blood clots.Agency for Healthcare Research and Quality.Blood thinner pills: your guide to using them safely.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Blood thinners.National Blood Clot Alliance.Majority (55 percent) of Americans taking blood thinners indicate they fear suffering from major bleeding; 73 percent more cautious with routine activities to avoid risk.MedlinePlus.Apixaban.MedlinePlus.Rivaroxaban.DailyMed,Label: Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban kit Xarelto- rivaroxaban granule, for suspension.Chen A, Stecker E, Warden BA.Direct oral anticoagulant use: a practical guide to common clinical challenges.Am Heart Assoc. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559DailyMed.Label: Eliquis- apixaban tablet, film coated.Aryal MR, Gosain R, Donato A, et al.Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world.Blood Adv. 2019;3(15):2381-2387. doi:10.1182/bloodadvances.2019000572Hernandez I, Zhang Y, Saba S.Comparison of the effectiveness and safety of apixaban, dabigatran, rivaroxaban, and warfarin in newly diagnosed atrial fibrillation.Am J Cardiol. 2017;120(10):1813-1819. doi:10.1016/j.amjcard.2017.07.092Fralick M, Colacci M, Schneeweiss S, et al.Effectiveness and safety of apixaban compared With rivaroxaban for patients with atrial fibrillation in routine practice: a cohort study.Ann Intern Med. 2020: doi:10.7326/M19-2522Ray WA, Chung CP, Stein CM, et al.Association of rivaroxaban vs apixaban with major ischemic or hemorrhagic events in patients with atrial fibrillation [published correction appears in JAMA. 2022(13):1294.JAMA. 2021;326(23):2395-2404. doi:10.1001/jama.2021.21222National Blood Clot Alliance.Prevent blood clots.National Blood Clot Alliance.Know your risk.National Blood Clot Alliance.Signs and symptoms of blood clots.Agency for Healthcare Research and Quality.Blood thinner pills: your guide to using them safely.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Blood thinners.National Blood Clot Alliance.Majority (55 percent) of Americans taking blood thinners indicate they fear suffering from major bleeding; 73 percent more cautious with routine activities to avoid risk.MedlinePlus.Apixaban.MedlinePlus.Rivaroxaban.DailyMed,Label: Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban kit Xarelto- rivaroxaban granule, for suspension.Chen A, Stecker E, Warden BA.Direct oral anticoagulant use: a practical guide to common clinical challenges.Am Heart Assoc. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559DailyMed.Label: Eliquis- apixaban tablet, film coated.Aryal MR, Gosain R, Donato A, et al.Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world.Blood Adv. 2019;3(15):2381-2387. doi:10.1182/bloodadvances.2019000572Hernandez I, Zhang Y, Saba S.Comparison of the effectiveness and safety of apixaban, dabigatran, rivaroxaban, and warfarin in newly diagnosed atrial fibrillation.Am J Cardiol. 2017;120(10):1813-1819. doi:10.1016/j.amjcard.2017.07.092Fralick M, Colacci M, Schneeweiss S, et al.Effectiveness and safety of apixaban compared With rivaroxaban for patients with atrial fibrillation in routine practice: a cohort study.Ann Intern Med. 2020: doi:10.7326/M19-2522Ray WA, Chung CP, Stein CM, et al.Association of rivaroxaban vs apixaban with major ischemic or hemorrhagic events in patients with atrial fibrillation [published correction appears in JAMA. 2022(13):1294.JAMA. 2021;326(23):2395-2404. doi:10.1001/jama.2021.21222National Blood Clot Alliance.Prevent blood clots.National Blood Clot Alliance.Know your risk.National Blood Clot Alliance.Signs and symptoms of blood clots.Agency for Healthcare Research and Quality.Blood thinner pills: your guide to using them safely.
MedlinePlus.Blood thinners.
National Blood Clot Alliance.Majority (55 percent) of Americans taking blood thinners indicate they fear suffering from major bleeding; 73 percent more cautious with routine activities to avoid risk.
MedlinePlus.Apixaban.
MedlinePlus.Rivaroxaban.
DailyMed,Label: Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban tablet, film coated Xarelto- rivaroxaban kit Xarelto- rivaroxaban granule, for suspension.
Chen A, Stecker E, Warden BA.Direct oral anticoagulant use: a practical guide to common clinical challenges.Am Heart Assoc. 2020;9(13):e017559. doi:10.1161/JAHA.120.017559
DailyMed.Label: Eliquis- apixaban tablet, film coated.
Aryal MR, Gosain R, Donato A, et al.Systematic review and meta-analysis of the efficacy and safety of apixaban compared to rivaroxaban in acute VTE in the real world.Blood Adv. 2019;3(15):2381-2387. doi:10.1182/bloodadvances.2019000572
Hernandez I, Zhang Y, Saba S.Comparison of the effectiveness and safety of apixaban, dabigatran, rivaroxaban, and warfarin in newly diagnosed atrial fibrillation.Am J Cardiol. 2017;120(10):1813-1819. doi:10.1016/j.amjcard.2017.07.092
Fralick M, Colacci M, Schneeweiss S, et al.Effectiveness and safety of apixaban compared With rivaroxaban for patients with atrial fibrillation in routine practice: a cohort study.Ann Intern Med. 2020: doi:10.7326/M19-2522
Ray WA, Chung CP, Stein CM, et al.Association of rivaroxaban vs apixaban with major ischemic or hemorrhagic events in patients with atrial fibrillation [published correction appears in JAMA. 2022(13):1294.JAMA. 2021;326(23):2395-2404. doi:10.1001/jama.2021.21222
National Blood Clot Alliance.Prevent blood clots.
National Blood Clot Alliance.Know your risk.
National Blood Clot Alliance.Signs and symptoms of blood clots.
Agency for Healthcare Research and Quality.Blood thinner pills: your guide to using them safely.
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