apixaban vs warfarin
Side-by-side comparison of apixaban and warfarin. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
moderate Known Drug Interaction
In ARISTOTLE, concomitant use of aspirin increased the bleeding risk on apixaban from 1.8% per year to 3.4% per year and concomitant use of aspirin and warfarin increased the bleeding risk from 2.7% per year to 4.6% per year.
Recommendation: Avoid taking these two blood thinners together unless your doctor tells you it is absolutely necessary. You will need frequent monitoring and blood tests to ensure your safety.
Apixaban (Eliquis) is a medicine that helps prevent blood clots. It is used to lower the risk of stroke and other serious problems caused by blood clots.
Warfarin is a medicine that helps prevent blood clots. It is used to treat and prevent dangerous clots from forming in your body.
Apixaban is used to lower the chance of stroke in people with an irregular heartbeat called atrial fibrillation. It also prevents blood clots in the legs (deep vein thrombosis or DVT) that can happen after hip or knee replacement surgery. Apixaban is also used to treat DVT and lung clots (pulmonary embolism or PE), and to prevent them from coming back.
Warfarin is used to prevent and treat blood clots in your veins and lungs. It can also prevent clots if you have atrial fibrillation (irregular heartbeat) or a replacement heart valve. After a heart attack, it can lower the risk of death, another heart attack, or a stroke.
Apixaban is a type of drug called a factor Xa inhibitor. It works by blocking a substance in the blood that helps clots form. This helps to keep your blood flowing smoothly.
Warfarin works by blocking your body's use of vitamin K. Vitamin K is needed to make blood clotting factors. By blocking vitamin K, warfarin makes your blood less likely to clot.
- • Bleeding more easily (like nosebleeds or heavier periods)
- • Bruising more easily
- • Bleeding from any tissue or organ
- Irregular heartbeat 3,970
- Shortness of breath 3,598
- Stroke 3,508
- Blood clot 2,806
- Heart problem 2,509
- INR increased 10,275
- Shortness of breath 8,408
- Interaction with another medicine 6,289
- Tiredness 6,141
- Feeling sick to your stomach 5,921
Apixaban has two important warnings. First, stopping apixaban too early can raise your risk of blood clots. Don't stop taking it without talking to your doctor. Second, if you have spinal anesthesia or a spinal puncture while taking apixaban, you could get a blood clot around your spine, which can cause long-term paralysis.
Warfarin can cause major or fatal bleeding. You must have your blood tested regularly (INR) while taking warfarin. Many things, like other medicines and diet changes, can affect your INR. Tell your doctor about any bleeding and follow their instructions to prevent bleeding.
Apixaban is not recommended during pregnancy because it may increase the risk of bleeding during pregnancy and delivery. Talk to your doctor about the risks and benefits of taking apixaban if you are breastfeeding. You may need to stop taking the drug or stop nursing.
Warfarin can harm your unborn baby, especially during the first three months of pregnancy. Do not take warfarin if you are pregnant, unless you have a mechanical heart valve and your doctor says the benefits outweigh the risks. Talk to your doctor if you are breastfeeding, and watch your baby for bruising or bleeding.
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How to Read This apixaban vs warfarin Comparison
apixaban is classified in the Direct Oral Anticoagulant (Factor Xa Inhibitor) drug class, while warfarin sits within the Vitamin K Antagonist (Anticoagulant) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, apixaban has 16,391 submissions while warfarin has 37,034. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to both medications are powerful blood thinners, and using them at the same time greatly increases the risk of dangerous bleeding. combining these drugs makes it much more difficult for your body to stop any bleeding that starts.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between apixaban and warfarin - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.