Two medicines, side by side
Apixaban vs rivaroxaban
Apixaban and rivaroxaban are both labeled for atrial fibrillation, blood clots (DVT and PE) and stroke prevention. Drugs@FDA records approvals of apixaban since 2012 and of rivaroxaban since 2011. Pharmacies paid $5.52 per Eliquis 5 mg tablet and $0.650 per rivaroxaban 2.5 mg tablet (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. Rivaroxaban's other strengths are brand-only: $19.54 per Xarelto 20 mg tablet. How each works, in its label's words: Apixaban, “Apixaban is a selective inhibitor of FXa.”; Rivaroxaban, “XARELTO is a selective inhibitor of FXa.”
Check it at the source: the apixaban FDA label on DailyMed (effective April 24, 2026); the rivaroxaban FDA label on DailyMed (effective September 10, 2026).
Highlights of the apixaban record
Apixaban (Eliquis) · label of April 24, 2026
(A) PREMATURE DISCONTINUATION OF ELIQUIS INCREASES THE RISK OF THROMBOTIC EVENTS (B) SPINAL/EPIDURAL HEMATOMA (A) PREMATURE DISCONTINUATION OF ELIQUIS INCREASES THE RISK OF THROMBOTIC EVENTS Premature discontinuation of any oral anticoagulant, including ELIQUIS, increases the risk of thrombotic events.
Used for
From the label: indicationsELIQUIS is a factor Xa inhibitor indicated: • to reduce the risk of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation. (1.1) • for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in adult patients who have undergone hip or knee replacement surgery. […]
On the market
- Earliest approval on file
- December 28, 2012
- Generic labelers
- 2 labelers
- Pharmacy cost
- $5.52 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the rivaroxaban record
Rivaroxaban (Xarelto) · label of September 10, 2026
(A) PREMATURE DISCONTINUATION OF XARELTO INCREASES THE RISK OF THROMBOTIC EVENTS, (B) SPINAL/EPIDURAL HEMATOMA A. Premature discontinuation of XARELTO increases the risk of thrombotic events Premature discontinuation of any oral anticoagulant, including XARELTO, increases the risk of thrombotic events.
Used for
From the label: indicationsXARELTO is a factor Xa inhibitor indicated: to reduce risk of stroke and systemic embolism in nonvalvular atrial fibrillation ( 1.1 ) for treatment of deep vein thrombosis (DVT) ( 1.2 ) for treatment of pulmonary embolism (PE) ( 1.3 ) for reduction in the risk of recurrence of DVT or PE ( 1.4 ) for the prophylaxis of DVT, which may lead to PE in patients undergoing knee or hip replacement surgery ( 1.5 ) for […]
On the market
- Earliest approval on file
- July 1, 2011
- Generic labelers
- 20 labelers
- Pharmacy cost
- $0.650 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 1
Source: FDA drug labels via openFDA (Apixaban label of April 24, 2026, Rivaroxaban label of September 10, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do apixaban and rivaroxaban differ on the record?
How each works, in its label's words: Apixaban, “Apixaban is a selective inhibitor of FXa.”; Rivaroxaban, “XARELTO is a selective inhibitor of FXa.”
Both are in FDA's class factor Xa inhibitors.
Half-life, in each label's words: Apixaban, “Apixaban has a total clearance of approximately 3.3 L/hour and an apparent half-life of approximately 12 hours …”; Rivaroxaban, “The terminal elimination half-life of rivaroxaban is 5 to 9 hours in healthy subjects aged 20 to 45 years.”
Both labels carry a boxed warning; the records quote them.
Generics: apixaban since 2019; rivaroxaban since 2025 (Drugs@FDA).
| Apixaban | Rivaroxaban | |
|---|---|---|
| Labeled for | Atrial fibrillation, Blood clots (DVT and PE), Stroke prevention | Atrial fibrillation, Heart attack and coronary artery disease, Blood clots (DVT and PE), Stroke prevention |
| Pharmacologic class | Factor Xa Inhibitor | Factor Xa Inhibitor |
| How it works (label) | Apixaban is a selective inhibitor of FXa. It does not require antithrombin III for antithrombotic activity. Apixaban inhibits free and clot-bound FXa, and prothrombinase activity. | XARELTO is a selective inhibitor of FXa. It does not require a cofactor (such as Anti-thrombin III) for activity. Rivaroxaban inhibits free FXa and prothrombinase activity. |
| Half-life (label) | Apixaban has a total clearance of approximately 3.3 L/hour and an apparent half-life of approximately 12 hours following oral administration. | The terminal elimination half-life of rivaroxaban is 5 to 9 hours in healthy subjects aged 20 to 45 years. |
| Earliest approval on file (Drugs@FDA) | December 28, 2012 | July 1, 2011 |
| First generic approved | December 23, 2019 | March 3, 2025 |
| Generic labelers (NDC) | 2 labelers | 20 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $5.52 per tablet (Eliquis 5 mg tablet) | $0.650 per tablet (Rivaroxaban 2.5 mg tablet) |
| 12-month price change | -43% | -81% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 0 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,522 | 206,938 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Rivaroxaban label, drug interactionsAvoid concurrent use of XARELTO with other anticoagulants due to increased bleeding risk unless benefit outweighs risk.
Source: FDA drug labels via openFDA
What next?
- Alternatives to apixaban
- every medicine labeled for the same conditions