Key takeaways
- Xarelto (rivaroxaban) and Eliquis (apixaban) are prescribed to prevent or treat blood clots in adults. Both Xarelto and Eliquis also have approved uses for children. Both drugs are also used to lower the risk of stroke and blood clots in adults with nonvalvular atrial fibrillation, as well as to treat deep vein thrombosis or pulmonary embolism in adults.
- Both drugs are available as tablets. Xarelto also comes in a liquid suspension form. And Eliquis also comes as sprinkles for oral suspension.
- Xarelto and Eliquis share similar side effects, including an increased risk of bleeding. Both drugs also have boxed warnings about the risk of blood clots if treatment is stopped prematurely and the risk of spinal or epidural hematoma after certain spinal injections.
While Eliquis and Xarelto are very similar, there are some differences. For example, Xarelto has several uses Eliquis isn’t approved for. (See the “What are Xarelto and Eliquis used for?” section for more information.)
Keep reading to find out more about how Xarelto and Eliquis are alike and different.
Note: For more information about these drugs, see this in-depth Xarelto article and this in-depth Eliquis article.
Whether you have health insurance or not, cost may be a factor when you’re considering these drugs.
Xarelto and Eliquis are brand-name drugs. A generic version of Xarelto (rivaroxaban oral tablets) is also available. Generic drugs contain the same active ingredient as the brand-name drug they are designed to mimic and tend to cost less.
Other factors that can affect the price of these medications include your treatment plan, whether you have health insurance (and what your particular plan benefits are if you do), and the pharmacy you use.
For other resources that might help you save on the price of these drugs, see this Xarelto cost article and this Eliquis cost article.
Get answers to some frequently asked questions about Xarelto and Eliquis.
How do Xarelto and Eliquis compare with Pradaxa?
Xarelto, Eliquis, and Pradaxa (dabigatran) are similar drugs, and all belong to a group of medications called blood thinners. Here are a few key similarities and differences:
- You take Xarelto, Eliquis, and Pradaxa by mouth. Xarelto and Eliquis come as tablets, oral suspension, and in various forms to mix with liquid to make an oral solution. Pradaxa comes as an oral capsule.
- Like Xarelto and Eliquis, Pradaxa is prescribed to prevent or treat certain blood clots in adults. Xarelto, Eliquis, and Pradaxa may also be used for this purpose in some children.
- These drugs can all cause bleeding, including serious bleeding, as a side effect.
To learn more about Pradaxa or other blood thinners, such as Plavix (clopidogrel) and Jantoven (warfarin), talk with your doctor or pharmacist.
Do older people have a higher risk of bleeding from Xarelto compared with Eliquis?
In older adults with atrial fibrillation, Xarelto carries
For Eliquis, the risk of bleeding is similar in older and younger people. But both drugs have a risk of this side effect for anyone who takes them, regardless of age.
To learn more about your risk of bleeding with Xarelto or Eliquis, talk with your doctor or pharmacist. They can also discuss the risks and benefits of taking Xarelto or Eliquis for your condition, including your risk of side effects.
Xarelto and Eliquis are prescribed to prevent or treat certain blood clots in adults. Xarelto and Eliquis may also be used to prevent or treat blood clots in some children. The following chart lists the uses for each medication.
| Use | Xarelto | Eliquis |
|---|---|---|
| lower the risk of stroke and blood clots in adults with nonvalvular atrial fibrillation (AFib) | ✓ | ✓ |
| treat deep vein thrombosis (DVT) or pulmonary embolism (PE), which are types of blood clots, in adults | ✓ | ✓ |
| lower the risk of DVT or PE in adults who have previously had one of these blood clots | ✓ | ✓ |
| lower the risk of DVT in adults getting a knee or hip replacement | ✓ | ✓ |
| lower the risk of a kind of blood clot called venous thromboembolism (VTE) in adults who have a risk of VTE during or after being treated in a hospital | ✓ | |
| lower the risk of heart and blood vessel problems in adults with coronary artery disease (CAD) | ✓ | |
| lower the risk of blood clots in adults with peripheral artery disease (PAD) | ✓ | |
| treat VTE and lower the risk of another clot in certain children | ✓ | ✓ |
| prevent blood clots in children with congenital heart disease after Fontan surgery | ✓ |
Xarelto or Eliquis and children
Xarelto is also prescribed for the following uses in children:
- treat VTE in children of any age
- lower the risk of VTE in children of any age who have previously had this type of blood clot
- lower the risk of blood clots in children ages 2 years and older who have a genetic heart condition and have had a surgery called the Fontan procedure
Please note the following restrictions for Xarelto use in children. It is not approved for children:
- less than 6 months of age
- less than 37 weeks of gestation at birth
- who had less than 10 days of oral feeding
- who have a body weight of less than 2.6 kg
A generic drug contains an exact copy of the active ingredient in a brand-name medication, but tends to cost less.
- Xarelto:
- Active ingredient: rivaroxaban
- Available as a generic: yes
- Eliquis:
- Active ingredient: apixaban
- Available as a generic: no
Here’s an overview of the dosages for Xarelto and Eliquis and how you’ll take either drug for conditions they both prevent or treat. The strengths of these drugs are in milligrams (mg) or milligrams per milliliter (mg/mL).
Dosage for preventing or treating blood clots in adults and children
| Xarelto for preventing or treating blood clots | Eliquis for preventing or treating blood clots | |
|---|---|---|
| Forms | tablet or liquid suspension, both of which you swallow | • tablet that you swallow • tablet for oral liquid suspension • powder (Eliquis Sprinkle) for oral liquid suspension |
| Strengths | • tablet: 2.5 mg, 10 mg, 15 mg, 20 mg • liquid suspension: 1 mg/mL | • tablet: 2.5 mg, 5 mg • tablet for oral suspension: 0.5 mg • powder for oral suspension: 0.15 mg |
| Dosage | dosage will depend on the treatment plan your doctor prescribes | dosage will depend on the treatment plan your doctor prescribes |
| How often to take | once or twice per day | twice per day |
Dosage for lowering risk of stroke or blood clots in adults with nonvalvular atrial fibrillation (AFib)
| Xarelto for nonvalvular AFib | Eliquis for nonvalvular AFib | |
|---|---|---|
| Forms | oral tablet | tablet that you swallow |
| Strengths | 2.5 mg, 10 mg, 15 mg, 20 mg | 2.5 mg, 5 mg |
| Dosage | dosage will depend on the treatment plan your doctor prescribes | dosage will depend on the treatment plan your doctor prescribes |
| How often to take | once per day | twice per day |
In addition, Xarelto may be prescribed for other uses than those listed here, including some in certain children. These are described in the “What are Xarelto and Eliquis used for?” section. The forms and strengths of the drug for these uses are the same as listed here. But your child’s dose will depend on the treatment plan their doctor prescribes. Your doctor or pharmacist can provide more information.
For more details about dosages of these drugs, check out this Xarelto dosage article and this Eliquis dosage article.
Xarelto and Eliquis are both blood thinners that can cause mild to serious side effects.
For more information about side effects both drugs can cause, check out this Xarelto side effects article and this Eliquis side effects article.
Mild side effects
Xarelto and Eliquis may cause mild side effects in some people. The following chart lists examples of mild side effects that have been reported with these drugs. This chart may not include all mild side effects of these medications.
| Side effect | Xarelto | Eliquis |
|---|---|---|
| anemia (low red blood cell level) | ✓ | |
| back pain | ✓ | |
| abdominal pain | ✓ | |
| dizziness | ✓ | |
| fatigue | ✓ | |
| itchiness | ✓ | |
| mild bruising or bleeding, such as nosebleeds | ✓ | ✓ |
| muscle cramps | ✓ | |
| nausea | ✓ | |
| difficulty sleeping | ✓ |
Serious side effects
In addition to the mild side effects listed in the previous section, serious side effects may occur with Xarelto or Eliquis use. See the following chart for a list of serious side effects that have been reported with these drugs.
| Side effect | Xarelto | Eliquis |
|---|---|---|
| increased bleeding risk, which may cause serious or life threatening bleeding | ✓ | ✓ |
| risk of blood clots if you stop taking the drug too soon* | ✓ | ✓ |
| risk of spinal or epidural hematoma after certain spinal injections* | ✓ | ✓ |
| allergic reaction | ✓ | ✓ |
| anticoagulant-related nephropathy | ✓ | |
| eosinophilic pneumonia | ✓ | |
| atraumatic splenic rupture (ruptured spleen with no apparent cause) | ✓ |
* Xarelto and Eliquis have a boxed warning for this side effect. To learn more, see the “What are the warnings for Xarelto and Eliquis?” section.
For more information on side effects of these drugs, see Xarelto’s prescribing information and Eliquis’s prescribing information.
Side effects in children
Children taking Eliquis or Xarelto may experience the same side effects as adults.
However, the most common side effects seen in children in Eliquis studies include headache, vomiting, and excessive menstrual bleeding. Each of these side effects occurred in at least 10% of children taking this medication.
The most common side effects seen in children in Xarelto studies include bleeding, cough, vomiting, and gastroenteritis. Each of these side effects occurred in at least 10% of children taking this medication.
The most common side effects seen in adults in the studies of both drugs were related to bleeding.
For more information about side effects of Eliquis or Xarelto in children, speak with your child’s doctor or a pharmacist.
You may wonder whether Xarelto and Eliquis are effective at treating your condition. These drugs are both prescribed for certain uses in adults. The following chart lists the uses that Xarelto and Eliquis share and whether the drugs are recommended for these uses in certain guidelines.
| Use | Guidelines | Recommend Xarelto? | Recommend Eliquis? |
|---|---|---|---|
| lower the risk of stroke and blood clots in adults with nonvalvular atrial fibrillation (AFib) | Journal of the American College of Cardiology | ✓ | ✓ |
| treat deep vein thrombosis (DVT) or pulmonary embolism (PE), which are types of blood clots, in adults | American Society of Hematology (ASH) | ✓ | ✓ |
| lower the risk of DVT or PE in adults who have previously had one of these clots | ASH | ✓ | ✓ |
| lower the risk of DVT in adults getting a knee or hip replacement | ASH | ✓ | ✓ |
Xarelto and Eliquis may not be right for you if you have certain medical conditions or other factors that affect your health. These are referred to as warnings or precautions.
Xarelto and Eliquis share some of the same warnings, but they also have different ones. Before starting treatment with either medication, be sure to talk with your doctor if any of the following warnings apply to you.
Boxed warnings
Xarelto and Eliquis have the following boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Risk of blood clots if you stop treatment too soon: Stopping treatment with Xarelto or Eliquis increases your risk of having a blood clot. Due to this risk, you should not stop taking either drug without speaking with your doctor first. They can suggest safe ways for you to stop Xarelto or Eliquis treatment.
Risk of spinal or epidural hematoma after certain spinal injections: While taking Eliquis or Xarelto, receiving certain spinal injections may cause bleeding around your spine or brain. These include spinal injections, epidural injections (an injection into the area around the spinal cord), and lumbar punctures (sometimes called spinal taps).
This bleeding may result in a spinal or epidural hematoma (a buildup of blood in your spine or brain). These kinds of hematomas can cause paralysis that is long term or even permanent.
The following factors may increase the risk of this side effect when taking Eliquis or Xarelto:
- if you’ve had surgery on or problems with your spine
- if you’re taking medications that affect your ability to form blood clots, including:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve)
- other blood thinners, such as aspirin or clopidogrel (Plavix)
- If you’ve had repeated or difficult spinal or epidural injections
If you must have a spinal or epidural injection while taking Xarelto or Eliquis, your doctor will closely monitor you for hematomas. After such a procedure, if you experience symptoms of a hematoma, contact your doctor immediately. Symptoms include:
- loss of bladder or bowel control
- numbness, tingling, or muscle weakness, especially in your feet and legs
- back pain
Other warnings
In addition to boxed warnings, Xarelto and Eliquis have other warnings. Before starting treatment with either of these medications, talk with your doctor if any of the following conditions or health factors apply to you.
- Warnings for both Xarelto and Eliquis:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or planning to become pregnant
- if you’re breastfeeding or planning to breastfeed
- if you have active bleeding or a bleeding problem, such as hemophilia
- if you have a condition called triple-positive antiphospholipid syndrome (APS)
- if you have an artificial heart valve
- if you have liver problems
- if you have kidney problems
- if you have an upcoming surgical, medical, or dental procedure
- if you have a pulmonary embolism that needs treatment with surgery or drugs to dissolve the blood clot
To learn more about the warnings for these drugs, see this in-depth Xarelto article and this in-depth Eliquis article.
The short answer: It’s possible.
Details: It may be possible to switch from Xarelto to Eliquis and vice versa, since both medications are prescribed for some of the same uses. (For more information, see the “What are Xarelto and Eliquis used for?” section.) Your doctor can discuss with you whether it’s safe for you to switch from one to the other.
Reminder: You should not switch drugs or stop your current treatment unless your doctor recommends it. If you’re interested in switching from Xarelto or Eliquis to the other drug, talk with your doctor. They’ll advise you on how best to transition from one medication to the other.
Disclaimer: Healthline 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.