| Atrial Fibrillation
Xarelto vs Pradaxa
Side-by-side clinical, coverage, and cost comparison for atrial fibrillation.Deep comparison between: Xarelto vs Pradaxa 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 signalsPradaxa has a higher rate of injection site reactions vs Xarelto based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Pradaxa but not Xarelto, including UnitedHealthcare
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Category
Xarelto
Pradaxa
At A Glance
Oral
Once or twice daily
Factor Xa inhibitor
Oral
Twice daily
Direct thrombin inhibitor
Indications
- Atrial Fibrillation
- Deep Vein Thrombosis
- Pulmonary Embolism
- Venous Thrombosis
- Coronary heart disease
- Peripheral Arterial Diseases
- Atrial Fibrillation
- Deep Vein Thrombosis
- Pulmonary Embolism
Dosing
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.
Atrial Fibrillation CrCl > 30 mL/min: 150 mg orally twice daily; CrCl 15-30 mL/min: 75 mg orally twice daily; reduce to 75 mg twice daily if CrCl 30-50 mL/min with concomitant dronedarone or systemic ketoconazole.
Deep Vein Thrombosis, Pulmonary Embolism Treatment: 150 mg orally twice daily after 5-10 days of parenteral anticoagulation (CrCl > 30 mL/min); recurrence reduction: 150 mg orally twice daily after previous treatment (CrCl > 30 mL/min).
Prophylaxis of DVT and PE Following Hip Replacement Surgery 110 mg orally on day 1 (1-4 hours after surgery and after hemostasis), then 220 mg once daily for 28-35 days (CrCl > 30 mL/min).
Pediatric VTE Weight-based dosage orally twice daily after at least 5 days of parenteral anticoagulant (ages 8 to <18 years); adjust dose per actual weight as treatment progresses.
Contraindications
- Active pathological bleeding
- Severe hypersensitivity reaction to rivaroxaban or any excipient (e.g., anaphylactic reactions)
- Active pathological bleeding
- History of serious hypersensitivity reaction to dabigatran, dabigatran etexilate, or any excipient (e.g., anaphylactic reaction or anaphylactic shock)
- Mechanical prosthetic heart valve
Adverse Reactions
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
Most common Bleeding events (major and minor), gastrointestinal adverse reactions (dyspepsia, nausea, vomiting, upper abdominal pain, diarrhea, gastritis-like symptoms)
Serious Intracranial hemorrhage, major gastrointestinal hemorrhage, anaphylactic reaction, anaphylactic shock
Postmarketing Agranulocytosis, neutropenia, thrombocytopenia, esophageal ulcer, angioedema, anticoagulant-related nephropathy, alopecia
Pharmacology
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.
Dabigatran and its acyl glucuronides are competitive, direct thrombin inhibitors that prevent thrombus formation by blocking thrombin-mediated conversion of fibrinogen to fibrin and inhibiting thrombin-induced platelet aggregation, acting on both free and clot-bound thrombin.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Xarelto
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (12/12)
Pradaxa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Xarelto
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Pradaxa
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (1/8) · Qty limit (1/8)
Humana
Xarelto
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Pradaxa
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$10/fillfill
Xarelto withMe Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Pradaxa.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.