Eliquis vs. Warfarin
See how Eliquis and Warfarin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Eliquis and warfarin both prevent dangerous blood clots, but Eliquis needs no routine blood testing while warfarin requires regular INR checks and dose adjustments.
Eliquis costs far more out of pocket than warfarin, which is one of the least expensive anticoagulants available.
Warfarin is the only oral anticoagulant approved for people with mechanical heart valves, a use Eliquis does not cover.
Eliquis vs. Warfarin Drug Summary
Eliquis
Eliquis (apixaban) is a Factor Xa inhibitor anticoagulant used to prevent stroke in atrial fibrillation, treat and prevent DVT and PE, and reduce clot risk after hip or knee replacement surgery. It's taken as a twice-daily tablet, with no routine blood testing required.
Warfarin
Warfarin (warfarin sodium) is a vitamin K antagonist anticoagulant used to treat and prevent DVT and PE, manage clot risk in atrial fibrillation or after valve replacement, and lower death or stroke risk after a heart attack. It's a once-daily tablet with doses adjusted by regular INR testing.
Eliquis vs. Warfarin Side Effects
Eliquis
Warfarin
Eliquis vs. Warfarin Dosage
Eliquis
Warfarin
| 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 mg to 5 mg once daily | Days 1-4 |
| Maximum dose | 2 mg to 10 mg once daily | Day 5 onward |
| Dose changes | 1 increase | Every 4 days |
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 |
Warfarin
| STAGE | DOSE | WHEN |
| Starting dose | 2 mg to 5 mg once daily | Days 1-4 |
| Maximum dose | 2 mg to 10 mg once daily | Day 5 onward |
| Dose changes | 1 increase | Every 4 days |
Eliquis vs. Warfarin Indications
Eliquis
Eliquis is an anticoagulant approved to lower stroke risk in atrial fibrillation not caused by heart valve disease, prevent blood clots after hip or knee replacement surgery, and treat DVT and PE. It's also approved to reduce the risk of clots recurring after initial treatment, and is one of few anticoagulants approved for children.
Stroke prevention in nonvalvular atrial fibrillation
DVT prevention after hip or knee replacement surgery
Treatment of DVT and pulmonary embolism (PE)
Reducing risk of recurrent DVT and PE
Warfarin
Warfarin is a vitamin K antagonist approved to treat and prevent DVT and PE, prevent stroke and clotting complications in atrial fibrillation or after mechanical heart valve replacement, and lower the risk of death or a repeat heart attack after a myocardial infarction. It has been used for decades and is still the only oral anticoagulant approved for mechanical heart valve patients.
Treatment and prevention of DVT and PE
Stroke and clot prevention in atrial fibrillation
Clot prevention after mechanical heart valve replacement
Reducing death and stroke risk after a heart attack
Eliquis vs. Warfarin Pros and Cons
Eliquis
Eliquis offers predictable dosing without routine blood monitoring, making it more convenient for many patients, though it carries a boxed warning about stopping it early and a much higher price than warfarin. It's not an option for people with mechanical heart valves, who still need warfarin.
Pros
No routine blood test monitoring required, unlike warfarin's INR checks
Far fewer food and drug interactions than warfarin
Specific reversal agent available for bleeding emergencies
Approved for pediatric VTE treatment from birth
Cons
Taken twice daily, while some other newer anticoagulants are once daily
Not approved for patients with mechanical heart valves
Costs roughly $550 to $606 a month without insurance, far more than warfarin's $4 to $35
Lacks warfarin's decades-long real-world safety track record
Warfarin
Warfarin requires regular INR monitoring and careful attention to diet and drug interactions, but it remains the only oral anticoagulant proven for mechanical heart valve patients and costs a fraction of newer options. Its long track record and low cost keep it in wide use despite the extra monitoring burden.
Pros
Costs roughly $4 to $35 per month, far less than Eliquis
Only oral anticoagulant approved for mechanical heart valve patients
Effect can be quickly reversed with vitamin K if needed
Decades of clinical use and well-established safety data
Cons
Requires frequent blood testing (INR) and dose adjustments
Vitamin K intake, genetics, and many drugs can alter effectiveness
Carries added risks like skin necrosis and calciphylaxis
Slower onset often requires bridging with another anticoagulant
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