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.
