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rivaroxaban vs warfarin

Side-by-side comparison of rivaroxaban 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

7.4 Anticoagulants and NSAIDs/Aspirin Coadministration of enoxaparin, warfarin, aspirin, clopidogrel and chronic NSAID use may increase the risk of bleeding [see Clinical Pharmacology (12.3) ].

Recommendation: This combination should generally be avoided unless specifically directed and monitored by your healthcare provider.

Drug Class
rivaroxaban Direct Oral Anticoagulant (Factor Xa Inhibitor)
warfarin Vitamin K Antagonist (Anticoagulant)
Type
rivaroxaban Prescription
warfarin Prescription
Summary
rivaroxaban

Rivaroxaban (Xarelto) is a drug that helps to prevent blood clots from forming. It is used to lower the risk of stroke and treat or prevent dangerous clots in your veins and lungs.

warfarin

Warfarin is a medicine that helps prevent blood clots. It is used to treat and prevent dangerous clots from forming in your body.

What It Treats
rivaroxaban

This medicine can help prevent strokes in people with an irregular heartbeat called atrial fibrillation. It also treats blood clots in the legs (deep vein thrombosis or DVT) and lungs (pulmonary embolism or PE). Rivaroxaban can also lower the risk of these clots coming back. It is also used to prevent blood clots after hip or knee replacement surgery and in acutely ill patients.

warfarin

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.

How It Works
rivaroxaban

Rivaroxaban is a factor Xa inhibitor. It blocks a substance in your blood called factor Xa. By blocking factor Xa, the medicine helps to prevent blood clots from forming.

warfarin

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.

Common Side Effects
rivaroxaban
  • Bleeding
  • Cough
  • Vomiting
  • Gastroenteritis (inflammation of the stomach and intestines)
warfarin
  • Bleeding from any tissue or organ
FAERS Reports
rivaroxaban
  • Bleeding in the stomach or intestines 21,559
  • Bleeding 7,713
  • Shortness of breath 7,149
  • Nosebleed 6,698
  • Tiredness 6,546
warfarin
  • 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
Serious Warnings
rivaroxaban

This medicine has two important warnings. First, stopping this medicine too early can increase your risk of blood clots. Do not stop taking it without talking to your doctor first. Second, if you receive spinal anesthesia or have a spinal puncture while taking this medicine, you have a risk of a blood clot forming around your spine, which can cause long-term paralysis.

warfarin

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.

Pregnancy
rivaroxaban

Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may cause bleeding problems during pregnancy and delivery. It is not known if this medicine passes into breast milk, so talk to your doctor about the risks and benefits of breastfeeding.

warfarin

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.

Also Compare, Nearby Drugs

How to Read This rivaroxaban vs warfarin Comparison

rivaroxaban 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, rivaroxaban has 49,665 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 these are both powerful blood thinners, and using them together significantly raises the chance of dangerous bleeding.. 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 rivaroxaban 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.