Two medicines, side by side
Enoxaparin vs rivaroxaban
Enoxaparin and rivaroxaban are both labeled for blood clots (DVT and PE) and heart attack and coronary artery disease. Drugs@FDA records approvals of enoxaparin since 1993 and of rivaroxaban since 2011. Pharmacies paid $6.45 per mL (Enoxaparin 100 mg/mL syringe) and $0.650 per rivaroxaban 2.5 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Rivaroxaban's other strengths are brand-only: $19.54 per Xarelto 20 mg tablet. In FDA's classes, enoxaparin is a low molecular weight heparin and rivaroxaban a factor xa inhibitor.
Check it at the source: the enoxaparin FDA label on DailyMed (effective May 28, 2026); the rivaroxaban FDA label on DailyMed (effective September 10, 2026).
Highlights of the enoxaparin record
Enoxaparin (Lovenox) · label of May 28, 2026
SPINAL/EPIDURAL HEMATOMAS Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures.
Used for
From the label: indicationsLovenox is a low molecular weight heparin (LMWH) indicated for: Prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness ( 1.1 ) Inpatient treatment of acute DVT with or without pulmonary embolism ( 1.2 ) Outpatient treatment of acute DVT without pulmonary embolism ( 1.2 ) Prophylaxis […]
On the market
- Earliest approval on file
- March 29, 1993
- Generic labelers
- 16 labelers
- Pharmacy cost
- $6.45 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 6
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 (Enoxaparin label of May 28, 2026, Rivaroxaban label of September 10, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do enoxaparin and rivaroxaban differ on the record?
In FDA's classes, enoxaparin is a low molecular weight heparin and rivaroxaban a factor xa inhibitor.
How each works, in its label's words: Enoxaparin, “Enoxaparin is a low molecular weight heparin which has antithrombotic properties.”; Rivaroxaban, “XARELTO is a selective inhibitor of FXa.”
Half-life, in each label's words: Enoxaparin, “Elimination half-life based on anti-Factor Xa activity was 4.5 hours after a single subcutaneous dose to about 7 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: enoxaparin since 2010; rivaroxaban since 2025 (Drugs@FDA).
| Enoxaparin | Rivaroxaban | |
|---|---|---|
| Labeled for | Angina, Heart attack and coronary artery disease, Blood clots (DVT and PE) | Atrial fibrillation, Heart attack and coronary artery disease, Blood clots (DVT and PE), Stroke prevention |
| Pharmacologic class | Low Molecular Weight Heparin | Factor Xa Inhibitor |
| How it works (label) | Enoxaparin is a low molecular weight heparin which has antithrombotic properties. | 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) | Elimination half-life based on anti-Factor Xa activity was 4.5 hours after a single subcutaneous dose to about 7 hours after repeated dosing. | 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) | March 29, 1993 | July 1, 2011 |
| First generic approved | July 23, 2010 | March 3, 2025 |
| Generic labelers (NDC) | 16 labelers | 20 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $6.45 per mL (Enoxaparin 100 mg/mL syringe) | $0.650 per tablet (Rivaroxaban 2.5 mg tablet) |
| 12-month price change | -26% | -81% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 6 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 57,205 | 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)
Do their labels mention each other?
Rivaroxaban label, drug interactionsCoadministration of enoxaparin, warfarin, aspirin, clopidogrel and chronic NSAID use may increase the risk of bleeding [see Clinical Pharmacology (12.3) ].
Source: FDA drug labels via openFDA
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 enoxaparin
- every medicine labeled for the same conditions