Eliquis vs. Xarelto: What’s the difference?

Eliquis (apixaban) and Xarelto (rivaroxaban) are direct oral anticoagulants used to prevent and treat blood clots. Here’s an in-depth comparison of the two medications.

How Eliquis and Xarelto Work

Both medications inhibit the Factor Xa enzyme, crucial in the blood clotting process, reducing the risk of clots.

Approved Uses

Eliquis and Xarelto are both approved for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and to reduce stroke risk in people with non-valvular atrial fibrillation.

Side Effects

Common side effects for both medications include minor bleeding and bruising. Serious potential side effects include severe bleeding and allergic reactions.

Drug Interactions

Both medications can interact with other drugs, including NSAIDs, certain antibiotics, and other anticoagulants, which can increase the risk of bleeding.

Boxed Warnings and Precautions

Both medications carry FDA Boxed Warnings regarding the risk of potentially severe spinal and epidural blood clots. They should be used with caution in patients with kidney or liver disease, bleeding disorders, or those undergoing spinal procedures.

Efficacy and Safety

Studies suggest that while both medications are effective, Eliquis may offer a lower risk of bleeding and possibly better outcomes in reducing blood clot risks.

Conclusion

The choice between Eliquis and Xarelto often depends on individual patient needs, side effect profiles, and specific medical conditions. Consultation with a healthcare provider is essential to choose the right medication.

Sources

  • Eliquis (apixaban) tablets, for oral use. Bristol Myers Squibb. Last updated 9/2021.
  • Xarelto (rivaroxaban) tablets, for oral use. Janssen Pharmaceutical. Last updated 2/2023.
  • Ray, W. et al. Association of Rivaroxaban vs Apixaban With Major Ischemic or Hemorrhagic Events in Patients with Atrial Fibrillation. Journal of the American Medical Association. 2021.
  • Aryal MR, 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.
  • Fralick, M., et al. Effectiveness and Safety of Apixaban Compared With Rivaroxaban for Patients With Atrial Fibrillation in Routine Practice: A Cohort Study. Annals of internal medicine, 2020.
  • Stroke, Clot Risk Halved in Patients with Heart Disease and Arrhythmia Who Took Blood Thinners Apixaban Versus Rivaroxaban. Penn Medicine. Accessed 2024.