What medication can you take in place of Xarelto?

Healthcare professionals prescribe Xarelto to reduce the risk of blood clots and strokes. It belongs to a class of drugs called direct oral anticoagulants (DOACs) or non-vitamin K antagonist oral anticoagulants (NOACs).

The generic name for Xarelto is rivaroxaban.

The brand name Xarelto is available in different forms, such as tablets and oral suspension (liquid). The specific Xarelto dosage may vary based on your medical condition and other individual factors.

Xarelto and generic rivaroxaban are available in various strengths, typically 10 milligrams (mg), 15 mg, and 20 mg tablets.

The Food and Drug Administration (FDA) has approved Xarelto for various conditions, including blood clots in people with:

• atrial fibrillation
• deep vein thrombosis (DVT)
• pulmonary embolism (PE)

Healthcare professionals may also prescribe Xarelto after surgery to reduce the risk of blood clots.

In some cases, they may explore alternative medications to Xarelto:

• if you cannot tolerate its side effects
• if it isn’t working as it should
• if it interacts with other medications that you are taking

DOAC alternatives to Xarelto

Common Xarelto alternatives in the DOAC drug class may include:

Apixaban

• Brand name: Eliquis
• Administration forms: Eliquis is available as a tablet for oral administration.
• Side effects: Common side effects of apixaban (Eliquis) may include nosebleeds, nausea, and other minor bleeding. Serious but rare side effects may include severe bleeding or blood clot formation. 

Dabigatran etexilate

• Brand name: Pradaxa
• Administration forms: Pradaxa comes in capsules that you take orally.
• Side effects: Common side effects of dabigatran etexilate (Pradaxa) may include indigestion, stomach pain, and gastrointestinal discomfort.

Edoxaban

• Brand name: Savaysa
• Administration forms: Savaysa is available as a tablet for oral administration.
• Side effects: Common side effects of edoxaban (Savaysa) may include nosebleeds, headache, and fatigue. Like other anticoagulants, it can increase the risk of bleeding, including severe bleeding. 

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Other blood thinners

DOACs directly inhibit specific clotting factors and may have a more predictable dosage regimen than older blood thinners, which require frequent monitoring.

DOACs generally have fewer drug interactions and dietary restrictions than other blood thinning medications. Still, your healthcare professional may opt for the latter in some cases.

Warfarin

• Brand name: Coumadin
• Mode of administration: Warfarin (Coumadin) is taken orally as tablets.
• Side effects: Common side effects may include bleeding, bruising, and skin tissue death. Warfarin (Coumadin) also requires dietary restrictions due to its interaction with vitamin K.

Enoxaparin

• Brand name: Lovenox
• Mode of administration: This is a low molecular weight heparin (LMWH) used to prevent blood clots. You or a doctor can administer it through subcutaneous injections.
• Side effects: Possible side effects may include bleeding, bruising, and skin reactions at the injection site.

Heparin

Heparin does not have a specific brand name due to its availability as a generic medication.

• Mode of administration: You or a doctor can administer heparin through subcutaneous or intravenous injections.
• Side effects: Side effects may include bleeding, bruising, and skin reactions at the injection site. Rare but serious side effects can include heparin-induced thrombocytopenia or allergic reactions.

Xarelto vs. Eliquis

Both Xarelto and Eliquis are DOACs that work by inhibiting specific clotting factors in the blood to prevent clots. You can take them orally, and do not require frequent monitoring or blood tests.

Side effects are also similar, such as risk of bleeding, bruising, and gastrointestinal discomfort.

However, you take Eliquis twice daily and Xarelto once daily.

The medications also differ in their approved uses. Xarelto is FDA-approved for multiple conditions, including DVT and PE. It also reduces the risk of stroke and systemic embolism in people with nonvalvular atrial fibrillation. 

Eliquis is FDA-approved for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation. It is also approved for treating DVT and PE. Eliquis has a shorter half-life (your body eliminates it quicker).

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Natural alternatives to Xarelto

There aren’t enough studies to prove that natural supplements or remedies are as effective as Xarelto in preventing blood clots.

However, some supplements, such as fish oil, may have mild anticoagulant properties. You can consider them as a part of a holistic approach to cardiovascular health. But they do not replace the need for medication in high risk cases.

Natural remedies may also interact with medications or have safety concerns. The quality and purity of supplements and natural remedies may vary, further complicating their safety and efficacy.

If you consider taking natural alternatives to Xarelto, consider discussing it with a healthcare professional before you start the medication. They can provide guidance based on your medical condition and any potential interactions or risks associated with natural remedies and supplements for blood clots.

Summary

Doctors prescribe Xarelto to reduce the risk of blood clots and strokes. If you are unable to tolerate the side effects of Xarelto, or if you need to switch to another medication, many alternative medications are available. These may include Eliquis and Savaysa, each comes with its unique benefits, risks, and considerations. 

Consider talking with a healthcare professional to determine the most appropriate medication for your health needs.