| Atrial Fibrillation
Sotylize vs Xarelto
Side-by-side clinical, coverage, and cost comparison for atrial fibrillation.Deep comparison between: Sotylize 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 Sotylize based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xarelto but not Sotylize, including UnitedHealthcare
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Category
Sotylize
Xarelto
At A Glance
Oral
Twice daily
Class II/III antiarrhythmic
Oral
Once or twice daily
Factor Xa inhibitor
Indications
- Ventricular arrhythmia
- Atrial Fibrillation
- Atrial Flutter
- Atrial Fibrillation
- Deep Vein Thrombosis
- Pulmonary Embolism
- Venous Thrombosis
- Coronary heart disease
- Peripheral Arterial Diseases
Dosing
Ventricular arrhythmia Initial 80 mg orally twice daily; increase by 80 mg/day every 3 days to a maximum 320 mg/day, with therapeutic response typically at 160-320 mg/day in two or three divided doses.
Atrial Fibrillation, Atrial Flutter Initial 80 mg orally twice daily; increase by 80 mg/day every 3 days provided QTc <500 msec; most patients respond at 120 mg twice daily.
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
- Baseline QT interval >450 msec
- Sinus bradycardia, sick sinus syndrome, or second and third degree AV block without a functioning pacemaker
- Congenital or acquired long QT syndromes
- Cardiogenic shock or decompensated heart failure
- Hypokalemia
- Bronchial asthma or related bronchospastic conditions
- Hypersensitivity to sotalol
- Active pathological bleeding
- Severe hypersensitivity reaction to rivaroxaban or any excipient (e.g., anaphylactic reactions)
Adverse Reactions
Most common (>=2%) Fatigue, bradycardia, dyspnea, proarrhythmia, asthenia, dizziness.
Serious Sustained ventricular tachycardia/ventricular fibrillation, Torsade de Pointes.
Postmarketing Emotional liability, slightly clouded sensorium, incoordination, vertigo, paralysis, thrombocytopenia, eosinophilia, leukopenia, photosensitivity reaction, fever, pulmonary edema, hyperlipidemia, myalgia, pruritus, alopecia.
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
Sotalol is a non-cardioselective beta-adrenoreceptor blocker (Vaughan Williams Class II) with cardiac action potential duration prolongation (Class III) antiarrhythmic properties; it slows heart rate, decreases AV nodal conduction, and increases refractory periods of atrial and ventricular muscle and conduction tissue.
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.
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Most Common Insurance
Anthem BCBS
Sotylize
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (0/12) · Qty limit (0/12)
Xarelto
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (12/12)
UnitedHealthcare
Sotylize
- Covered on 4 commercial plans
- PA (3/8) · Step Therapy (0/8) · Qty limit (0/8)
Xarelto
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Sotylize
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (0/3)
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
Cost estimate not availablePAF Co-Pay Relief: Cardiac Arrhythmias
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$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.