Warfarin vs. Savaysa
See how Warfarin and Savaysa compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Warfarin is an older vitamin K antagonist that needs regular blood testing, while Savaysa is a newer factor Xa inhibitor taken at a fixed daily dose without routine monitoring.
Savaysa is not recommended for atrial fibrillation patients with very good kidney function, a situation where warfarin remains effective.
Warfarin costs far less out of pocket than Savaysa, but Savaysa avoids the dietary restrictions and frequent INR checks warfarin requires.
Warfarin vs. Savaysa Drug Summary
Warfarin
Warfarin is a vitamin K antagonist that has been used since 1954 to prevent and treat blood clots, including those linked to atrial fibrillation, heart valve replacement, and pulmonary embolism. It is taken as a daily tablet, but the dose must be adjusted over time based on regular INR blood tests.
Savaysa
Savaysa (edoxaban) is a factor Xa inhibitor approved in 2015 to prevent stroke in atrial fibrillation and to treat deep vein thrombosis and pulmonary embolism. It is taken as a single fixed-dose tablet each day and does not require routine blood test monitoring.
Warfarin vs. Savaysa Side Effects
Warfarin
Savaysa
Warfarin vs. Savaysa Dosage
Warfarin
Savaysa
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 60 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 1 increase | 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 |
Savaysa
| STAGE | DOSE | WHEN |
| Starting dose | 60 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Warfarin vs. Savaysa Indications
Warfarin
Warfarin treats and prevents a wide range of clotting problems, including venous thromboembolism, pulmonary embolism, and clots related to atrial fibrillation or mechanical heart valves. It is also used after a heart attack to lower the risk of death, another heart attack, or stroke.
Venous thromboembolism prevention and treatment
Pulmonary embolism prevention and treatment
Stroke prevention in atrial fibrillation
Savaysa
Savaysa is approved to lower the risk of stroke in people with nonvalvular atrial fibrillation and to treat deep vein thrombosis and pulmonary embolism. It is not approved for people with mechanical heart valves or for atrial fibrillation patients whose kidneys clear the drug too quickly.
Stroke prevention in nonvalvular atrial fibrillation
Deep vein thrombosis (DVT) treatment
Pulmonary embolism (PE) treatment
Warfarin vs. Savaysa Pros and Cons
Warfarin
Warfarin has decades of data across more clinical situations than Savaysa, including mechanical heart valves and certain pregnancies, and it costs far less. The tradeoff is regular blood testing and sensitivity to diet and other medications.
Pros
Effective across more approved conditions, including heart valves
Only oral anticoagulant option for pregnant patients with mechanical valves
Effect can be reversed quickly with vitamin K if needed
Roughly $4 to $35 per month, far less than Savaysa
Cons
Requires regular INR blood testing to find the right dose
Affected by vitamin K in food and many drug interactions
Takes several days to reach a stable therapeutic effect
Risk of skin necrosis or calciphylaxis in rare cases
Savaysa
Savaysa offers simpler, fixed daily dosing without routine blood test monitoring, but it is not an option for mechanical heart valves and works less well with excellent kidney function. It also costs substantially more than warfarin out of pocket.
Pros
No routine blood test monitoring required
Simple fixed daily dose, not adjusted by lab results
Faster onset of anticoagulant effect than warfarin
Fewer known food and drug interactions than warfarin
Cons
Not recommended for atrial fibrillation with very good kidney function
Cannot be used with mechanical heart valves
Needs several days of injectable anticoagulant first for DVT/PE
Roughly $483 to $561 per month, much more than warfarin
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