| Atrial Fibrillation
Multaq vs Xarelto
Side-by-side clinical, coverage, and cost comparison for atrial fibrillation.Deep comparison between: Multaq vs Xarelto with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXarelto has a higher rate of injection site reactions vs Multaq based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xarelto but not Multaq, including UnitedHealthcare
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Category
Multaq
Xarelto
At A Glance
Oral
Twice daily
Multi-class antiarrhythmic
Oral
Once or twice daily
Factor Xa inhibitor
Indications
- Atrial Fibrillation
- Atrial Fibrillation
- Deep Vein Thrombosis
- Pulmonary Embolism
- Venous Thrombosis
- Coronary heart disease
- Peripheral Arterial Diseases
Dosing
Atrial Fibrillation 400 mg twice daily orally; one tablet with the morning meal and one tablet with the evening meal.
Atrial Fibrillation 20 mg once daily with evening meal (CrCl >50 mL/min); 15 mg once daily with evening meal (CrCl <=50 mL/min), oral.
Deep Vein Thrombosis, Pulmonary Embolism 15 mg twice daily with food for 21 days, then 20 mg once daily with food for remaining treatment, oral.
Venous Thrombosis 10 mg once daily with or without food: for recurrence prevention after at least 6 months of standard anticoagulant treatment; or 35 days post-hip replacement surgery; or 12 days post-knee replacement surgery; or 31-39 days total for prophylaxis in acutely ill medical patients, oral.
Coronary heart disease, Peripheral Arterial Diseases 2.5 mg twice daily with or without food, in combination with aspirin 75-100 mg once daily, oral.
Contraindications
- Permanent atrial fibrillation (patients in whom normal sinus rhythm will not or cannot be restored)
- Symptomatic heart failure with recent decompensation requiring hospitalization or NYHA Class IV symptoms
- Second or third-degree atrioventricular (AV) block, or sick sinus syndrome (except when used in conjunction with a functioning pacemaker)
- Bradycardia
- Concomitant use of strong CYP3A inhibitors (ketoconazole, itraconazole, voriconazole, cyclosporine, telithromycin, clarithromycin, nefazodone, ritonavir)
- Concomitant use of erythromycin
- Concomitant use of QT-prolonging drugs or herbal products (phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, Class I and III antiarrhythmics)
- Liver or lung toxicity related to previous use of amiodarone
- QTc interval >500 ms or PR interval >280 ms
- Severe hepatic impairment
- Hypersensitivity to the active substance or to any of the excipients
- Active pathological bleeding
- Severe hypersensitivity reaction to rivaroxaban or any excipient (e.g., anaphylactic reactions)
Adverse Reactions
Most common (>=1%) Diarrhea, nausea, abdominal pain, vomiting, dyspepsia, asthenia, bradycardia, skin rash
Serious New or worsening heart failure, liver injury, pulmonary toxicity, QT prolongation, hypokalemia and hypomagnesemia with potassium-depleting diuretics
Postmarketing New or worsening heart failure, atrial flutter with 1:1 AV conduction, liver injury, interstitial lung disease (pneumonitis, pulmonary fibrosis), anaphylactic reactions including angioedema, vasculitis including leukocytoclastic vasculitis
Most common Bleeding complications, wound secretion, pruritus, back pain, abdominal pain, muscle spasm, dizziness, fatigue
Serious Intracranial hemorrhage, gastrointestinal bleeding, fatal bleeding, spinal/epidural hematoma
Postmarketing Agranulocytosis, thrombocytopenia, jaundice, cholestasis, hepatitis, hypersensitivity, anaphylactic reaction, anaphylactic shock, angioedema, hemiparesis, anticoagulant-related nephropathy, eosinophilic pneumonia, Stevens-Johnson syndrome, DRESS, atraumatic splenic rupture
Pharmacology
Dronedarone is an antiarrhythmic agent with properties belonging to all four Vaughan-Williams classes (I, II, III, and IV), though the mechanism of action and contribution of each class to the clinical effect is unknown; it also acts as a moderate inhibitor of CYP3A and CYP2D6 and inhibits P-glycoprotein transport.
Rivaroxaban is a selective oral Factor Xa (FXa) inhibitor that does not require a cofactor for activity; by inhibiting free FXa and prothrombinase activity, it decreases thrombin generation and indirectly inhibits thrombin-induced platelet aggregation.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Multaq
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (0/12) · Qty limit (12/12)
Xarelto
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Multaq
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (3/8)
Xarelto
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Multaq
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Xarelto
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Multaq.
$10/fillfill
Xarelto withMe Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.