Xarelto (rivaroxaban) and Eliquis (apixaban) are brand-name prescription medications. They’re approved by the Food and Drug Administration (FDA) to treat or help prevent blood clots in certain situations.

This article explains the key similarities and differences between Xarelto and Eliquis. If you’re thinking about taking either drug, talk with your doctor. By reviewing this information with them, your doctor can help determine whether Xarelto, Eliquis, or a different blood thinner may be better for you.

Note: For more comprehensive information about these two drugs, you can refer to our Xarelto and Eliquis articles.

Key differences between Xarelto and Eliquis

These are a couple of the main differences between Xarelto and Eliquis:

  • Dosage: Xarelto is typically taken once daily, while Eliquis is typically taken twice daily. However, this can vary. (See “Dosages, forms, and administration” below.)
  • Conditions treated: Xarelto and Eliquis are both used to treat and help prevent blood clots in adults. However, Xarelto is also used for this purpose in certain children. (See “Uses of Xarelto vs. Eliquis” below.)

How much Xarelto or Eliquis costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks for price estimates of Xarelto and Eliquis.

Both Xarelto and Eliquis are brand-name drugs. Neither drug is available in generic form.* Brand-name medications are often more expensive than generics.

For more information about the two drugs and cost, see these articles about Xarelto and Eliquis. You can also learn about Xarelto and Medicare, as well as Eliquis and Medicare.

* The Food and Drug Administration (FDA) has approved a generic form of Eliquis. However, the generic form is not currently available for use.

Below are answers to some common questions about Xarelto and Eliquis.

Do Xarelto and Eliquis differ in their uses for AFib, DVT, and pulmonary embolism?

No, Xarelto and Eliquis have the same approved uses for atrial fibrillation (AFib), deep vein thrombosis (DVT), and pulmonary embolism. For details, see “Uses of Xarelto vs. Eliquis” below.

What’s the difference between Xarelto and Eliquis in older adults?

Xarelto is more likely to cause bleeding problems in older adults (ages 65 years and older) than in younger people. Eliquis is not known to have an age-related risk of bleeding. The side effects of Eliquis in older adults are generally the same as in younger people.

If you have additional questions about the differences between Xarelto and Eliquis in older adults, talk with your doctor.

How do Xarelto and Eliquis compare with drugs such as Pradaxa and Plavix?

Below are a few ways Xarelto and Eliquis compare with Pradaxa and Plavix.

XareltoEliquisPradaxaPlavix
Active ingredientrivaroxabanapixabandabigatranclopidogrel
Drug classdirect-acting oral anticoagulant (blood thinner)direct-acting oral anticoagulantdirect-acting oral anticoagulantantiplatelet
Usesto treat or help prevent blood clots in certain situationsto treat or help prevent blood clots in certain situationsto treat or help prevent blood clots in certain situationsto lower the risk of heart attack and stroke in certain situations
Formoral tabletoral tabletoral capsuleoral tablet
Frequencyonce or twice dailytwice dailyonce or twice dailyonce daily

To learn more about how Xarelto and Eliquis compare with Pradaxa and Plavix, talk with your doctor.

Is the risk of bleeding greater with Xarelto or Eliquis?

The risk of bleeding may be greater with Xarelto than with Eliquis. This is based on results of studies that looked at both drugs after they became available as prescriptions.

For example, this review of studies and this review of insurance claims found the risk of bleeding to be higher with Xarelto than Eliquis.

However, keep in mind that the effects of Xarelto and Eliquis will vary from person to person. The severity of side effects one person has with these medications could be different from your experience.

To learn more about what to expect with Xarelto or Eliquis treatment, talk with your doctor.

Here’s a quick look at the standard dosage and administration for Xarelto and Eliquis for the conditions both drugs treat or help prevent.

Both Xarelto and Eliquis are approved to:

Dosage for blood clot and stroke prevention with AFib

Xarelto for blood clot and stroke prevention with AFibEliquis for blood clot and stroke prevention with AFib
Formoral tabletoral tablet
Strengths• 2.5 milligrams (mg)
• 10 mg
• 15 mg
• 20 mg
• 2.5 mg
• 5 mg
Dose15 mg or 20 mg5 mg
Frequencyonce dailytwice daily
Foodwith foodwith or without food

Dosage for treatment of DVT or PE

Xarelto for treatment of DVT or PEEliquis for treatment DVT or PE
Formoral tabletoral tablet
Strengths• 2.5 mg
• 10 mg
• 15 mg
• 20 mg
• 2.5 mg
• 5 mg
Dose• starting dose: 15 mg
• maintenance dose: 20 mg
• starting dose: 10 mg
• maintenance dose: 5 mg
Frequency• starting dosage: twice daily for 21 days
• maintenance dosage: once daily
• starting dosage: twice daily for 7 days
• maintenance dosage: twice daily
Foodwith foodwith or without food

Dosage for DVT or PE prevention after treatment

Xarelto for DVT or PE prevention after treatmentEliquis for DVT or PE prevention after treatment
Formoral tabletoral tablet
Strengths• 2.5 mg
• 10 mg
• 15 mg
• 20 mg
• 2.5 mg
• 5 mg
Dose10 mg2.5 mg
Frequencyonce dailytwice daily
Foodwith or without foodwith or without food

Dosage for DVT or PE prevention after hip or knee replacement

Xarelto for DVT or PE prevention after hip or knee replacementEliquis for DVT or PE prevention after hip or knee replacement
Formoral tabletoral tablet
Strengths• 2.5 mg
• 10 mg
• 15 mg
• 20 mg
• 2.5 mg
• 5 mg
Dose10 mg2.5 mg
Frequencyonce dailytwice daily
Foodwith or without foodwith or without food

Note: For more information about Xarelto’s dosage, see this article. To learn details about Eliquis and dosage, refer to this article. You can also talk with your doctor.

Keep reading to learn more about the effectiveness of Xarelto and Eliquis.

Review of studies. Here’s a brief look at whether Xarelto or Eliquis was found to be more effective for helping prevent or treat certain conditions.

Xarelto and Eliquis are both used to help prevent blood clots and stroke in adults with nonvalvular atrial fibrillation (AFib). A review of studies and a review of insurance claims found Eliquis to be more effective than Xarelto for this purpose. However, another review of insurance claims found that Xarelto and Eliquis were equally effective.

It’s important to note that these results may not apply to your individual health situation. Be sure to talk with your doctor to see whether Xarelto or Eliquis may be right for you.

Prescribing information. For information about how these drugs performed in clinical trials, see the prescribing information for Xarelto and Eliquis. Keep in mind that trial results may not apply to your individual health situation.

Treatment guidelines. Another way to determine whether a drug is considered effective is to look at treatment guidelines.

When an organization includes certain drugs in treatment guidelines, this means that research has shown the drug to be safe and effective.

Xarelto and Eliquis are recommended as treatment options for people with AFib in guidelines from the American Heart Association and other organizations.

Both drugs are also recommended as treatment options in blood clot prevention and blood clot treatment guidelines from the American Society of Hematology.

Here’s information about the generic status of Xarelto and Eliquis, as well as details on their active ingredients.

XareltoEliquis
Generic availablenono*
Active ingredientrivaroxabanapixaban
Drug classdirect-acting oral anticoagulant (blood thinner)direct-acting oral anticoagulant

* The Food and Drug Administration (FDA) has approved a generic form of Eliquis. However, the generic form is not currently available for use.

Xarelto and Eliquis have been approved by the Food and Drug Administration (FDA) for the following uses.

* Xarelto is approved in combination with aspirin for this use.

Xarelto or Eliquis and children

Xarelto is FDA-approved for the following uses in children:

  • treatment of VTE in children of any age
  • helping prevent VTE in children of any age after this condition has been treated
  • helping prevent blood clots in children ages 2 years and older after a certain heart procedure for congenital heart disease

Eliquis is not approved for any uses in children.

Note: For more information about the drugs’ uses, see our articles about Xarelto and Eliquis.

Both Xarelto and Eliquis are used to treat or help prevent blood clots in certain situations. These drugs can cause some of the same side effects as well as some different ones. Some of the side effects reported for these drugs are mentioned below.

For more details about side effects of Xarelto, see this article or refer to the Xarelto prescribing information. To learn more about side effects of Eliquis, see the Eliquis prescribing information. Your doctor can also help answer side effect questions you have about either drug.

Mild side effects

The following table lists some of the more commonly reported mild side effects of Xarelto and Eliquis. The table may also include mild side effects that are less common but that you might have concerns about in some cases.

Mild side effectsXareltoEliquis
bruisingxx
nauseax
anemia (low level of red blood cells)x
fatiguex
pain in the abdomen, back, arms, or legsx
dizzinessx
muscle spasmx
insomniax
itchingx
mild allergic reactionx*x

These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

* An allergic reaction is possible after taking Xarelto, but this side effect wasn’t reported in clinical trials. Allergic reaction has been reported since Xarelto became available as a prescription.

Serious side effects

The following table lists the reported serious side effects of Xarelto and Eliquis.

Serious side effectsXareltoEliquis
risk of blood clots in the spine with spinal procedures*xx
increased risk of blood clots if treatment is stopped early*xx
mental health effects, such as depression and anxietyx
serious bleeding, such as gastrointestinal bleedingxx
severe allergic reactionx†x

If you have serious side effects while taking Xarelto or Eliquis, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.

* Xarelto and Eliquis have a boxed warning for this side effect. A boxed warning is a serious warning from the FDA. To learn more, see “Precautions for Xarelto and Eliquis” below.
† An allergic reaction is possible after taking Xarelto, but this side effect wasn’t reported in clinical trials. Allergic reaction has been reported since Xarelto became available as a prescription.

Xarelto and Eliquis may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs share some of the same precautions, and they may also have different ones. Some of these precautions are mentioned below.

Boxed warnings

Xarelto and Eliquis have boxed warnings. These are serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Risk of blood clots in the spine with spinal procedures. Certain procedures may require an injection into the spine or epidural space (the area around the spinal cord). Having this type of injection while taking Xarelto or Eliquis increases the risk of a blood clot forming near the brain or spine. Having blood clots in these areas could lead to serious complications, including paralysis.

If you need to receive a spinal or epidural injection while taking Xarelto or Eliquis, your doctor will monitor you for blood clots in the brain or spine. Tell them right away if you have any of the following sensations in your feet, legs, or back:

  • tingling
  • pain
  • numbness
  • muscle weakness

Also, tell your doctor if you have trouble controlling your bladder or bowels. These could indicate a blood clot in the brain or spine. Your doctor will advise you on what to do if you have these symptoms.

Increased risk of blood clots if treatment is stopped early. Stopping Xarelto or Eliquis without your doctor’s recommendation can lead to blood clots. Depending on the location of the blood clot, it could cause trouble breathing. The clot may also cause pain or swelling in the affected area. If the clot travels to the brain, it could lead to a stroke.

Due to this risk, it’s important that you do not stop taking Xarelto or Eliquis without your doctor’s approval. If they tell you it’s safe to stop taking the drug, your doctor may prescribe another medication for your condition.

Precautions

In addition to boxed warnings, Xarelto and Eliquis have other precautions.

If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before taking Xarelto or Eliquis.

PrecautionXareltoEliquis
if you’ve had an allergic reaction to either drug or any of its ingredientsxx
if you’re pregnant or thinking about becoming pregnantxx
if you’re breastfeeding or thinking about breastfeedingxx
if you have active (current) bleeding, such as a bleeding ulcerxx
If you’ve had a heart valve replacementxx
if you have a surgery plannedxx
if you have kidney problemsxx
if you have liver problemsxx
if you have triple-positive antiphospholipid syndromexx

Note: For more comprehensive information about these two drugs, you can refer to our Xarelto and Eliquis articles. You can also see our articles about Xarelto interactions and Eliquis interactions.

Switching between Xarelto and Eliquis is possible.

If you’d like to know more about switching between Xarelto and Eliquis, talk with your doctor. They can give you additional details and help determine the best course of action for your personal situation.

Even if two drugs treat the same condition or are in the same drug class, your body can still respond differently. It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.

Some key points to remember when comparing Xarelto and Eliquis include:

  • Xarelto is usually taken once daily. Eliquis is usually taken twice daily. Keep in mind that this can vary depending on the conditions the drugs are used for.
  • Both Xarelto and Eliquis are used to treat and help prevent blood clots in adults. Xarelto also has approved uses in children, while Eliquis does not.

If you’d like to learn more about Xarelto or Eliquis, talk with your doctor or pharmacist. They can help answer any questions you have about similarities and differences between the drugs. They can also help determine if one medication or the other might work well for you.

Note: For more information about your condition, see our cardiovascular health hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.