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Compare Xarelto vs. Warfarin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Rivaroxaban (Xarelto) and warfarin (Coumadin) are both medications used to prevent and treat blood clots, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). However, they belong to different medication classes. Rivaroxaban is a direct-acting oral anticoagulant (DOAC) that works by blocking factor Xa, while warfarin is a vitamin K antagonist that prevents blood clots by blocking vitamin K. Rivaroxaban is typically taken once or twice a day, depending on the condition, and does not require regular blood tests, whereas warfarin is taken once daily with dose adjustments based on international normalized ratio (INR) levels. Rivaroxaban is only available as a brand-name medication, while warfarin is available as a lower-cost generic. Bleeding, bruising, and skin discoloration are common side effects of both medications. Rivaroxaban and warfarin can interact with many medications, including other medications that thin the blood such as nonsteroidal anti-inflammatory drugs (NSAIDs). Warfarin requires dietary consistency with vitamin K intake for optimal effects. Both medications have serious bleeding risks, and they both have an antidote available in case of emergency.

  • Xarelto (rivaroxaban)
    Warfarin (Coumadin)
  • Xarelto (rivaroxaban)
    Warfarin (Coumadin)

  • Summary of Xarelto vs. Warfarin

    Summary for Direct-acting oral anticoagulant (DOAC)
    Prescription only

    Xarelto (rivaroxaban) is a prescription blood thinner used to prevent and treat blood clots. It can lower the risk of serious problems like stroke, deep vein thrombosis (DVT), or pulmonary embolism (PE). It's comes as a tablet or liquid and is taken by mouth. Your dose depends on why you're taking it, so it could be once or twice a day. The most common side effect is bleeding, which can sometimes be serious or life-threatening. Xarelto (rivaroxaban) is available as both a brand-name and a generic medication.

    Summary for Vitamin K antagonist
    Prescription only

    Warfarin (Coumadin) is a blood thinner (anticoagulant). It's used to prevent and treat blood clots in adults and children with conditions such as deep vein thrombosis (DVT) or pulmonary embolism (PE). Warfarin (Coumadin) is taken by mouth, typically once daily. Your provider will adjust the dose based on your international normalized ratio (INR). Taking too much warfarin (Coumadin) can lead to side effects like bruising and serious bleeding. If needed, your provider can give you an antidote to reverse the effects of warfarin (Coumadin).

  • Indications of Xarelto vs. Warfarin

    Indications for

    Adults:

    •Lower the risk of stroke and blood clots in people with atrial fibrillation (AFib) not caused by a heart valve problem
    •Treat blood clots in the legs (deep vein thrombosis (DVT)) or lungs (pulmonary embolism (PE))
    •Lower the risk of DVT or PE coming back after treatment
    •Prevent DVT and PE after knee or hip replacement surgery
    •Prevent blood clots in people in the hospital or recently released who are at high risk
    •Lower the risk of serious heart problems, like heart attack or stroke, in people with coronary artery disease (CAD), taken with aspirin
    •Lower the risk of blood clots and related problems in people with peripheral artery disease (PAD), taken with aspirin

    Children:

    •Treat blood clots and lower the risk of new clots in children from birth to under 18 years old
    •Prevent blood clots in children 2 years and older with congenital heart disease (CHD) after a Fontan procedure
    Indications for
    •Prevention and treatment blood clots in the veins
    •Prevention and treatment blood clots linked to atrial fibrillation (AFib) or heart valve replacement
    •Prevention of more blood clots and to lower risk of death after a heart attack

  • Pros and Cons of Xarelto vs. Warfarin

    Pros and Const for Direct-acting oral anticoagulant (DOAC)
    Pros
    •No regular blood monitoring required
    •Available as a tablet or liquid that's taken by mouth
    •Approved for both children and adults
    Cons
    •Most common side effect is bleeding
    •Not easily reversible in life-threatening bleeds
    •Can interact with many medications
    Pros and Const for Vitamin K antagonist
    Pros
    •Each strength of tablet is a unique color, making it easy to tell them apart
    •Only needs to be taken once a day
    •Has an antidote available in case of an emergency
    •Available as a lower-cost generic
    Cons
    •Only prevents new blood clots from forming or getting bigger; it doesn't work on existing blood clots
    •Requires regular blood draws to check INR levels
    •Interacts with foods and many commonly-prescribed medications
    •Not safe to take during pregnancy

  • Common Side Effects of Xarelto vs. Warfarin

    Common Side Effects for

    Adults

    •Any bleeding (Up to 28%)

    Children

    •Any bleeding (36%)
    •Cough (16%)
    •Vomiting (14%)
    •Stomach virus (13%)
    •Rash (9%)
    Common Side Effects for
    •Bleeding
    •Bruising

  • Warnings of Xarelto vs. Warfarin

    Common Side Effects for
    •Higher risk of blood clots if stopped too early
    •Paralysis in the spine
    •Bleeding
    •Interactions with other medications
    •Risk of pregnancy-related bleeding
    •Not recommended in people with prosthetic heart valves
    •Not recommended in people with antiphospholipid syndrome
    Common Side Effects for
    •Severe or life-threatening bleeding
    •Risk of blood clots from stopping too early
    •Risk of fat-containing clots
    •Calcium build-up in blood vessels (calciphylaxis)
    •Skin or tissue death and risk of gangrene
    •Not for use during pregnancy

  • Prices with our coupons for Xarelto vs. Warfarin

    Learn more about Xarelto
    Learn more about Warfarin

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