Xarelto vs. Savaysa
See how Xarelto and Savaysa compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Xarelto and Savaysa are both once-daily oral factor Xa inhibitors used to prevent stroke and treat blood clots, but Xarelto covers more approved uses, including surgical VTE prophylaxis.
Savaysa's dosing is simpler, with just two possible doses, while Xarelto requires a twice-daily start dose for the first three weeks when treating DVT or PE.
Savaysa should not be used for stroke prevention in atrial fibrillation patients with very good kidney function, since studies showed it worked less well than warfarin in that group.
Xarelto vs. Savaysa Drug Summary
Xarelto
Xarelto (rivaroxaban) is a factor Xa inhibitor that lowers the risk of stroke in atrial fibrillation and treats or prevents blood clots like DVT and PE. It's taken as an oral tablet, usually once daily, though some uses start with a twice-daily dose for three weeks.
Savaysa
Savaysa (edoxaban) is a factor Xa inhibitor used to lower stroke risk in atrial fibrillation and to treat DVT or PE. It's taken as a single oral tablet once a day, at either 60 mg or 30 mg depending on weight, kidney function, and other medications.
Xarelto vs. Savaysa Side Effects
Xarelto
Savaysa
Xarelto vs. Savaysa Dosage
Xarelto
Savaysa
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Day 22 onward |
| Dose changes | 3 increases | Every 21 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 |
Xarelto
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 20 mg once daily | Day 22 onward |
| Dose changes | 3 increases | Every 21 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 |
Xarelto vs. Savaysa Indications
Xarelto
Xarelto is FDA-approved for a wide range of clotting conditions, from atrial fibrillation-related stroke prevention to DVT and PE treatment and prevention. It's also approved for VTE prophylaxis after hip or knee replacement surgery and in acutely ill hospitalized patients.
Stroke prevention in nonvalvular atrial fibrillation
Treatment of DVT and PE
Reducing risk of DVT/PE recurrence
Savaysa
Savaysa is FDA-approved for stroke prevention in nonvalvular atrial fibrillation and for treating DVT or PE. It is not approved for VTE prevention after surgery, and it isn't recommended for AFib patients whose kidneys work very well, since it was less effective than warfarin in that group.
Stroke prevention in nonvalvular atrial fibrillation
Treatment of DVT
Treatment of PE
Xarelto vs. Savaysa Pros and Cons
Xarelto
Xarelto has the broadest set of FDA-approved uses among direct factor Xa inhibitors, covering AFib, VTE treatment, and surgical VTE prevention. It also has a specific reversal agent for bleeding emergencies, andexanet alfa, and has been on the market longer with an established safety record.
Pros
Approved for surgical VTE prophylaxis, unlike Savaysa
Reversal agent (andexanet alfa) available for bleeding
Oral suspension option for children or swallowing issues
Cons
Initial DVT/PE treatment requires twice-daily dosing for 3 weeks
Boxed warning for spinal or epidural hematoma with spinal procedures
More dosing steps to track during the titration period
Savaysa
Savaysa's dosing is simpler than Xarelto's, with only two possible daily doses and no titration period. It has fewer FDA-approved uses, though, and carries a boxed warning against use in atrial fibrillation patients with very good kidney function.
Pros
Simpler dosing: one tablet a day, no titration phase
Only two dose strengths to manage (60 mg or 30 mg)
No twice-daily start dose needed for DVT or PE treatment
Cons
Not approved for VTE prevention after hip or knee surgery
Boxed warning: less effective in AFib patients with excellent kidney function
Requires 5 to 10 days of injectable blood thinner first for DVT/PE
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