Eliquis vs. Lovenox

See how Eliquis and Lovenox compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Eliquis is a pill taken by mouth twice a day, while Lovenox is a shot given under the skin, so the two suit very different care settings.

  • Eliquis is built for long-term outpatient use like atrial fibrillation, while Lovenox is mostly used short-term in hospitals or right after surgery.

  • Both drugs carry boxed warnings about increased clotting risk if stopped early and about bleeding into the spine during epidural procedures.

Eliquis vs. Lovenox Drug Summary

Eliquis

Eliquis (apixaban) is a factor Xa inhibitor, an oral blood thinner that lowers stroke risk in atrial fibrillation and treats or prevents blood clots like DVT and PE. It comes as a tablet taken twice a day, with the exact dose depending on why it was prescribed.

Lovenox

Lovenox (enoxaparin) is a low molecular weight heparin, an injectable blood thinner used to prevent and treat blood clots after surgery, during hospital stays for acute illness, and alongside other therapy for heart attack. It is given as a shot under the skin, usually once or twice a day, at a dose based on weight or indication.

Eliquis vs. Lovenox Side Effects

Eliquis

Most common
epistaxis (up to 2.9%)
contusion (up to 1.8%)
hematuria (up to 1.7%)
menorrhagia (up to 1.4%)

Lovenox

Most common
anemia (up to 16%)
hemorrhage (up to 13%)
fever (up to 8%)
peripheral edema (up to 6%)

Eliquis vs. Lovenox Dosage

Eliquis

Dosage
Dosage Table
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

Lovenox

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg every 12 hours At the start
Maximum dose 30 mg IV bolus once If needed
Dose changes 3 increases As tolerated

Eliquis vs. Lovenox Indications

Eliquis

Eliquis is FDA-approved to reduce the risk of stroke and blood clots in people with nonvalvular atrial fibrillation, and to treat or prevent DVT and PE. It's also approved to prevent blood clots after hip or knee replacement surgery, and for VTE treatment in children from birth.

  • Stroke and blood clot prevention in atrial fibrillation

  • Blood clot prevention after hip or knee replacement surgery

  • Treatment of DVT and PE

  • Prevention of recurrent DVT and PE

Lovenox

Lovenox is FDA-approved to prevent blood clots after surgery or during hospital stays for acute illness, and to treat existing DVT and PE. It's also approved for use with aspirin to manage unstable angina, heart attack, and certain cardiac procedures.

  • Blood clot prevention after surgery or during hospitalization

  • Treatment of DVT and PE

  • Unstable angina and non-Q-wave heart attack, with aspirin

  • Treatment of ST-elevation heart attack, with aspirin

Eliquis vs. Lovenox Pros and Cons

Eliquis

Eliquis suits long-term, at-home use because it comes as a pill with no routine blood monitoring required. It is generally well covered for its approved uses, though it costs more out of pocket than a generic injectable and has no generic version yet.

Pros

  • Oral tablet, no injections needed

  • No routine blood monitoring required

  • Approved for long-term stroke prevention in atrial fibrillation

  • Reversal agent available for serious bleeding

Cons

  • Twice-daily dosing, unlike once-daily anticoagulants

  • Not approved for mechanical heart valves or antiphospholipid syndrome

  • Carries a boxed warning against early discontinuation

  • Roughly $550 to $606 per month without insurance, no generic yet

Lovenox

Lovenox works well for short courses around surgery or hospitalization, and its long history of use gives clinicians a strong safety track record. It requires injections and weight-based dosing, but a generic version makes it far cheaper than Eliquis for many patients.

Pros

  • Can be self-injected at home once or twice daily

  • Decades of clinical use across many hospital and surgical settings

  • Generic enoxaparin costs roughly $30 to $150 per month, well below brand Eliquis

  • Sometimes used off-label in pregnancy, when data on Eliquis is limited

Cons

  • Requires subcutaneous injections rather than a pill

  • Not approved for long-term stroke prevention in atrial fibrillation

  • Dosing is often weight-based and needs renal adjustment

  • Injection-site bruising and irritation are common

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