Eliquis vs Xarelto: Cost, Uses & Differences
If your doctor prescribes a blood thinner, you will likely be choosing Eliquis vs Xarelto. Both are direct oral anticoagulants that help reduce the formation of harmful or life-threatening blood clots. But they are not identical. Their active ingredients, dosing schedules, and indications vary.
Understanding the differences between Eliquis and Xarelto can help you feel more confident in your healthcare provider’s medication recommendation. Doctors choose based on both medications’ cost, the patient’s budget, insurance coverage, current medications/supplements, kidney and liver health, bleeding risk, and the condition being treated.
Do not start, stop, or switch either medication without a doctor’s approval, or you may not see the benefits and may experience side effects.
What Are the Differences Between Eliquis and Xarelto?
| Difference | Eliquis (apixaban) | Xarelto (rivaroxaban) |
| Active ingredient | Apixaban | Rivaroxaban |
| Drug class | Direct factor Xa inhibitor | Direct factor Xa inhibitor |
| Available strengths | 2.5 mg, 5 mg | 2.5 mg, 10 mg, 15 mg, 20 mg |
| Dosing frequency | Usually twice daily, depending on the condition | Once or twice daily, depending on the condition |
| Food requirements | Can be taken with or without food | Some doses/regimens should be taken with food |
How They Work
The pathway of action of Eliquis and Xarelto is generally the same. As direct factor Xa inhibitors, both block factor Xa, the essential protein that generates thrombin (the blood clot), and slow the blood-clotting process.
However, some pharmacological studies found minor differences in how Eliquis and Xarelto bind to free and clot-bound factor Xa and in their precise inhibition kinetics.
Eliquis vs Xarelto: Uses & Effectiveness
Both Eliquis and Xarelto can be effective, when taken as directed, to prevent or treat several types of blood clots because they share the same mechanism of action. They generally share major indications like reducing the risk of stroke, pulmonary embolism, and deep vein thrombosis following certain hip or knee replacement surgeries. However, clinical studies have found differences in safety and effectiveness across patient populations and treatment durations.
Eliquis has no approved uses. But Xarelto is additionally approved for reducing the risk of cardiovascular events and is prescribed to patients with coronary artery disease or peripheral artery disease.
Eliquis vs Xarelto: Cost & Insurance Coverage
The final Eliquis vs Xarelto price can vary considerably depending on the country where the patient lives or makes a purchase, the prescribed strength and quantity, the pharmacy selected, insurance or Medicare coverage, brand or generic availability, and available savings coupons or patient assistance programs. For more information, see our guide on:
Eliquis Cost Without Insurance
In the United States, Eliquis and Xarelto are priced differently for Medicare beneficiaries, depending on their prescription drug plan and stage of insurance coverage. Currently, eligible Medicare beneficiaries receive a maximum negotiated price of $521 for a 30-day supply of Eliquis and $517 for a 30-day supply of Xarelto.
Insurance coverage can considerably lower the final amount a patient pays out of pocket for either medicine. Medicare Part D plans generally cover eligible outpatient prescription drugs. But the exact copayment or coinsurance depends on the patient’s plan. To see which drug is most covered by insurance, patients should check their formulary and see which tier applies. A doctor or pharmacist can also help with coverage and available alternatives.
If you’re concerned about prescription costs and want to choose an effective, reasonably priced option, ask the pharmacist about participating pharmacies, check your insurance benefits, and explore eligible manufacturer assistance or savings programs. If you can’t continue with the prescribed drug because of your low pocket money, don’t just switch or stop taking the medicine without asking a clinician simply to reduce your expense, as this could be risky.
Eliquis vs Xarelto: Side Effects, Risks & Interactions
Both Eliquis and Xarelto reduce blood clotting, so bleeding is the most common potential risk. Some patients experience minor bleeding or bruising, while others may have serious bleeding, which requires immediate medical attention.
Some comparative studies suggest that patients taking Eliquis have lower rates of certain bleeding outcomes than those taking Xarelto.
Risk factors include the patient’s age, liver or kidney function, other medications, previous bleeding episodes, and the recommended dose. Patients should discuss any persistent or unusual symptoms with their doctor.
When it comes to their safe combination with other medicines, both Eliquis and Xarelto can interact with drugs affecting metabolism or increase the risk of bleeding. Harmful interactions are noted with some other blood thinners, antiplatelet medicines, and certain painkillers. To avoid interactions, share a list of all prescriptions, over-the-counter products, vitamins, and supplements.
What Decides the Clinician’s Choice of Prescription Drug?
A clinician decides based on Eliquis vs Xarelto differences, in the context of the patient:
- Complete medical records, including bleeding history
- Convenience to follow the prescribed regimen
- Reason for anticoagulation
- Kidney and liver function
- Dosing schedule/frequency
- Other medicines intake
- Insurance coverage
- Age
Final Takeaway
Eliquis and Xarelto are both oral anticoagulants, the factor Xa inhibitors with several overlapping uses and side effects and risks. But they differ in active ingredients, chemical structures, strengths, dosing, approved indications, some interaction profiles, and pricing.
Treatment decisions should not be based solely on Eliquis vs Xarelto cost; they should also consider medical history, age, bleeding risk, kidney health, other medications, and the diagnosis.
Frequently Asked Questions
Is Eliquis safer than Xarelto?
Maybe, in certain patients. Some comparative clinical studies have reported a lower bleeding rate in patients being treated for venous thromboembolism with Eliquis than Xarelto. However, a patient’s safety with any medicine depends on the dose, kidney health, medical condition, other medications, age, and bleeding risk, which the prescribing doctor can assess before writing a prescription.
Which lasts longer, Eliquis or Xarelto?
Xarelto lasts slightly longer than Eliquis in the patient’s body because of its slightly longer half-life. This is why the recommended dose for most conditions is one tablet daily for Xarelto and twice daily for Eliquis. However, the exact longevity of the effect depends on the condition being treated, prescribed dose, and other individual factors.
Can you switch from Xarelto to Eliquis?
Not without your prescribing doctor’s approval. Your healthcare provider will allow the switch only if it’s clinically appropriate and will plan the right timing for changing the medicine. The switch depends on the patient’s condition being treated, bleeding risk, dose, and kidney function.
Do Eliquis and Xarelto have the same drug interactions?
Both medicines can interact with the same class of medications. However, their interaction warnings and recommended precautions vary. Therefore, patients starting blood thinners must provide a complete list of prescription drugs, over-the-counter medicines, supplements, and herbal products they are currently taking before the doctor prescribes Eliquis or Xarelto, to avoid harmful interactions and ensure no product’s efficacy is altered.
Are Eliquis and Xarelto taken at the same time each day?
Eliquis is usually prescribed twice a day with enough time between doses, generally at the same time each day. Xarelto dosing varies by indication; it may be once or twice daily and may be taken with food. Always confirm the dosing schedule with your prescribing doctor.
Can Eliquis and Xarelto be used for the same conditions?
Both medicines are prescribed for the same indications, such as prevention and treatment of stroke, deep vein thrombosis, and pulmonary embolism. However, Xarelto has some additional approved indications related to the cardiovascular system.
References:
Medical News Today. Xarelto vs. Eliquis: Similarities and Differences
WithPower. Eliquis vs. Xarelto.