Xarelto® and Pradaxa® are among a new wave of blood thinners dethroning warfarin, doctors’ prescription choice for over 60 years. Both drugs were designed to sidestep the risks of warfarin, which include brain hemorrhages and other bleeding episodes. They also don’t require the frequent monitoring and regular blood tests that warfarin does, or the dietary and lifestyle changes. While Xarelto and Pradaxa may show promising benefits for patients needing an anticoagulant, they’re actually quite different from each other. As a result, patients should carefully consider the benefits and side effects when comparing Xarelto versus Pradaxa.
Xarelto Versus Pradaxa: New Anticoagulant Drugs Cost More
Neither Xarelto nor Pradaxa requires regular blood monitoring or frequent follow-up visits. With warfarin, patients need blood tests at least once a month to ensure it’s working correctly. Vitamin K (a nutrient commonly found in leafy greens) acts as an antidote to reverse warfarin’s blood-thinning effect during emergencies. Patients who consume too many foods containing Vitamin K, such as salads, risk reducing warfarin’s efficacy levels in their bloodstream.
Xarelto and Pradaxa also have something else in common: a much higher price point. Both medications cost about $3,000 per year, while generic warfarin (also known as Coumadin or Jantoven) costs around $200 annually.
Efficacy Studies Published on Xarelto Versus Pradaxa
Two studies demonstrate both Xarelto and Pradaxa’s efficacy over warfarin. No head-to-head efficacy studies exist specifically comparing Xaralto versus Pradaxa. Of course, this would offer more insight into how the two drugs differ from each other.
In the RE-LY trial, Pradaxa taken twice daily (150mg) proved superior to warfarin for reducing stroke/peripheral embolic events by 34%. Pradaxa also lowered the risk of hemorrhagic stroke by 74%. Observed major bleeding rates were comparable to warfarin. The ROCKET AF trial showed a daily 20mg dose of Xarelto was non-inferior to warfarin for reducing stroke and non-central nervous system risk in embolism in AF (atrial fibrillation) patients. Xarelto’s major bleeding event risk appeared comparable to that of warfarin and Pradaxa. However, Xarelto wasn’t determined to be a superior blood thinner in the trial’s intention-to-treat analysis.
Each drug uses a different physiological mechanism to thin a patient’s blood. Pradaxa directly inhibits thrombin production (a protein involved in clotting). Xarelto interferes with a protein called factor Xa being metabolized in the liver. These mechanism differences may account for any efficacy variations.
Xarelto Versus Pradaxa: Side Effect Risks
Slight variances between Xarelto and Pradaxa in dosing, treatment and side effects do exist. However, the main difference is that Pradaxa has a reversal agent while Xarelto does not. Both prescription drugs are blood thinners. During an extreme bleeding episode, lack of an antidote to reverse anticoagulation may result in serious life-threatening complications, including death. Luckily, Pradaxa has a reversal agent called Praxbind® (generic name: idaruczumab) that immediately reverses the drug’s anticoagulant effects. For this reason, Pradaxa seems to be a much safer choice for most blood thinner patients. Xarelto’s lack of antidote means during a severe bleeding episode, there’s no agent available to help coagulate the blood. Therefore, an affected patient may bleed out.
What You Can Do
Lawsuits have been filed against the manufacturers of both Pradaxa and Xarelto. Due to its lack of reversal agent, Xarelto patients who experienced life-threatening effects appear to have a stronger case. If you or a loved one took Xarelto and experienced uncontrolled side effects, like internal bleeding, blood clots or death, you may have a case. Fill out a free claim review form to have an experienced attorney see if you may be eligible for compensation.
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.