Pradaxa vs. Eliquis: 5 Key Differences to Consider
Key takeaways:
Pradaxa (dabigatran) and Eliquis (apixaban) are both direct-acting oral anticoagulants (DOACs). But they block different enzymes (proteins) involved in the clotting process to prevent blood clots.
Pradaxa and Eliquis both come in multiple dosage forms. But you can crush Eliquis tablets if you have trouble swallowing pills, while Pradaxa capsules must be swallowed whole.
Eliquis may be less likely than Pradaxa to cause upset stomach or severe bleeding. It’s also safe for those with severe kidney issues. But Pradaxa is a safer choice for those with moderate-to-severe liver problems.
Pradaxa and Eliquis are both available as brand-name medications. But you can also find Pradaxa capsules as a lower-cost generic. GoodRx can help make your prescription more affordable.
Access savings on related medications
Table of contents
Pradaxa (dabigatran) and Eliquis (apixaban) are two common blood thinners. They help treat and prevent blood clots and lower the risk of a stroke, especially for people with atrial fibrillation (an irregular heartbeat) or after certain surgeries.
Both medications help treat and prevent blood clots, but they work in different ways and have unique features. Understanding the key differences when it comes to Pradaxa versus Eliquis can help you have a more informed conversation with your healthcare team. Here are 5 differences to consider.
1. Pradaxa and Eliquis work differently to prevent blood clots
Pradaxa and Eliquis are both direct-acting anticoagulants (DOACs). They’re considered first-choice options for preventing blood clots in most people. And unlike warfarin (Coumadin, Jantoven), neither medication requires frequent blood tests or a specific diet. But Eliquis and Pradaxa work in slightly different ways.
Pradaxa blocks thrombin, an enzyme involved in the final step of forming a blood clot. Pradaxa is the only oral DOAC that works this way. Eliquis, on the other hand, blocks Factor Xa, an enzyme involved in an earlier step of blood clot formation.
Pradaxa and Eliquis are considered similarly effective at preventing blood clots. But Pradaxa reaches its maximum effect faster than Eliquis — typically within 2 hours of your first dose. Eliquis starts working a few hours after your first dose, but takes about 3 days to reach optimal levels in the body.
2. Eliquis has more flexibility for taking it than Pradaxa
Eliquis comes in three different dosage forms:
2.5 mg and 5 mg oral tablets
0.5 mg tablets for oral suspension (liquid)
0.15 mg Sprinkle capsules for oral suspension
Blood thinner 101: Understand the difference between antiplatelet and anticoagulant medications, and why one may be preferred over another.
Blood thinner interactions: Learn about medications that interact with blood thinners to help avoid unwanted issues in advance.
Best blood thinners for atrial fibrillation (AFib): Direct-acting oral anticoagulants (DOACs) are typically best for AFib — here’s why.
The lower-dose forms of Eliquis are designed to form an oral liquid. They’re intended for children who need to take the medication. But you can also crush Eliquis oral tablets and mix them with water, apple juice, or applesauce. This is a helpful option for adults who have trouble swallowing pills.
Pradaxa, on the other hand, comes in two different dosage forms:
75 mg, 110 mg, and 150 mg oral capsules
20 mg, 30 mg, 40 mg, 50 mg, 110 mg, and 150 mg oral pellet packets
Unlike Eliquis tablets, you cannot open Pradaxa capsules if you have trouble swallowing pills. They must be swallowed whole and intact.
Pradaxa oral pellets are only FDA approved for children. You can mix them with mashed carrots, applesauce, or mashed banana. Or you can mix them with apple juice. Pradaxa oral pellets aren’t interchangeable with the oral capsules, and the recommended dosages are different between the two dosage forms.
Because of these differences in dosage forms, Eliquis may be a better option for adults who have trouble swallowing pills.
3. Pradaxa and Eliquis have different side effects to consider
All blood thinners come with a risk of bleeding. But the risk of major bleeding may be slightly lower with Eliquis than with Pradaxa.
Stomach problems, such as heartburn and nausea, are also more common with Pradaxa than with Eliquis. Taking Pradaxa with a full glass of water is recommended to help reduce this side effect.
4. Eliquis may be a safer option if you’re living with kidney problems, but Pradaxa is likely safer for those with liver problems
Eliquis may be generally safer for patients with mild-to-moderate kidney issues. But you may need a lower Eliquis dose if you’re living with severe kidney problems.
Pradaxa, on the other hand, isn’t recommended for those with severe kidney problems. This is because Pradaxa relies mainly on the kidneys to clear it from the body. Severe kidney issues can lead to higher Pradaxa levels in the body, which raises your bleeding risk. Eliquis may be a safer option for you in this case.
Though, when it comes to liver problems, Pradaxa may be the safer option. The liver doesn’t play a role in removing Pradaxa from your system. It does, however, remove Eliquis from the body. So those living with moderate-to-severe liver problems are not recommended to take Eliquis.
Your healthcare team will review your medical history when choosing the best blood thinner for you. Make sure they’re aware of any existing kidney or liver problems.
5. Pradaxa has stricter storage requirements than Eliquis
Pradaxa capsules are very sensitive to moisture. So, unlike many other pills, it must be kept in its original bottle or blister pack. Once a bottle of Pradaxa is opened, it’s only good for 4 months. So it’s best to avoid opening more than one bottle at a time to ensure the capsules remain safe and effective.
Eliquis doesn’t have these restrictions and can be safely stored in a daily or weekly pill organizer. If you like to use a pill organizer or travel frequently, Eliquis may be a more convenient option for you.
There are ways to save on Eliquis and Pradaxa
Pradaxa and Eliquis are both available as brand-name medications. But you can also find Pradaxa capsules as a lower-cost generic. GoodRx can help you navigate the ways to save on your prescription.
Save with GoodRx. GoodRx can help you save over 60% off the average retail price of generic Pradaxa capsules. Generic Pradaxa’s price at certain pharmacies is as low as $66.18 with a free GoodRx discount.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 per month for Eliquis using a savings card from the manufacturer. You may also be able to get a 30-day free trial card from your prescriber in certain cases. A copay savings card may also lower the price of Pradaxa oral pellets to $10 per month.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Eliquis’s patient assistance program, which offers the medication free of cost.
The bottom Line
Pradaxa (dabigatran) and Eliquis (apixaban) are both effective blood thinners. But there are some differences to consider between Pradaxa versus Eliquis.
Both medications are direct-acting oral anticoagulants (DOACs). But they target different enzymes (proteins) involved in the clotting process. Eliquis may be a better option if you have trouble swallowing pills. It's often a safer choice than Pradaxa for those with severe kidney issues. Pradaxa may be better for those with moderate to severe liver problems. But it requires more careful storage and may be more likely to cause stomach discomfort.
Your healthcare team can help determine which blood thinner is the best option for you based on your health needs and lifestyle.
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References
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