Eliquis vs. Coumadin
See how Eliquis and Coumadin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Eliquis is a factor Xa inhibitor taken twice daily without routine blood testing, while Coumadin is a vitamin K antagonist that requires regular INR monitoring.
Coumadin is the only oral anticoagulant approved for patients with mechanical heart valves, an indication Eliquis does not have.
Eliquis costs significantly more out of pocket than Coumadin, which is available as a low-cost generic warfarin.
Eliquis vs. Coumadin Drug Summary
Eliquis
Eliquis (apixaban) is a factor Xa inhibitor used to prevent stroke in atrial fibrillation and to treat or prevent blood clots like DVT and PE. It's taken as a tablet twice daily and doesn't require routine blood monitoring.
Coumadin
Coumadin (warfarin) is a vitamin K antagonist used to prevent and treat blood clots, including in atrial fibrillation, DVT/PE, and mechanical heart valves. It's taken once daily but requires regular INR blood tests to keep dosing in a safe range.
Eliquis vs. Coumadin Side Effects
Eliquis
Coumadin
Eliquis vs. Coumadin Dosage
Eliquis
Coumadin
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg twice daily | Days 1-7 |
| Maximum dose | 2.5 mg twice daily | If needed |
| Dose changes | 2 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 2 to 5 mg once daily | Days 1-5 |
| Maximum dose | 2 to 10 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Eliquis
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg twice daily | Days 1-7 |
| Maximum dose | 2.5 mg twice daily | If needed |
| Dose changes | 2 increases | As tolerated |
Coumadin
| STAGE | DOSE | WHEN |
| Starting dose | 2 to 5 mg once daily | Days 1-5 |
| Maximum dose | 2 to 10 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Eliquis vs. Coumadin Indications
Eliquis
Eliquis is FDA-approved to reduce the risk of stroke in people with nonvalvular atrial fibrillation and to treat or prevent DVT and PE. It's also used to prevent blood clots after hip or knee replacement surgery and to treat VTE in children.
Stroke prevention in nonvalvular atrial fibrillation
DVT prophylaxis after hip or knee replacement
Treatment of DVT and PE
Reducing risk of recurrent DVT and PE
Coumadin
Coumadin is FDA-approved to prevent and treat venous thrombosis and PE, and to reduce stroke risk in atrial fibrillation. It's also used to prevent clotting in people with mechanical heart valves and to reduce death or recurrent heart attack after an MI.
Venous thrombosis and PE treatment
Stroke prevention in atrial fibrillation
Clot prevention with mechanical heart valves
Reducing death and reinfarction after MI
Eliquis vs. Coumadin Pros and Cons
Eliquis
Eliquis works as a direct factor Xa inhibitor, so it doesn't require the routine blood testing that warfarin does. It's generally easier to dose consistently since it isn't affected by vitamin K in food, but it isn't an option for people with mechanical heart valves.
Pros
No routine blood monitoring needed
Fewer food and drug interactions than warfarin
Approved for pediatric VTE treatment
Specific reversal agent available for bleeding
Cons
Not approved for mechanical heart valves
Requires twice-daily dosing
Roughly $550 to $606 per month without insurance
Coumadin
Coumadin is a decades-old vitamin K antagonist that requires regular INR monitoring to keep dosing in a safe range. It costs much less out of pocket than Eliquis, but food and drug interactions make it harder to manage day to day. It remains the only oral anticoagulant approved for people with mechanical heart valves.
Pros
Approved for mechanical heart valve patients
Roughly $40 to $100 per month before insurance
Long-established safety record since 1954
Once-daily dosing
Cons
Requires regular INR blood monitoring
Significant interactions with food and drugs
Not safe during pregnancy
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.