Compare Coumadin vs. Xarelto

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Coumadin
(Warfarin)

Xarelto
(Rivaroxaban)

Prevents blood clots. Coumadin (Warfarin) is an old, cheap, and effective medicine to prevent blood clots, but it requires some monitoring, dose adjustments, and even lifestyle changes.Prevents blood clots. Xarelto (Rivaroxaban) is a good medication for preventing blood clots. It doesn't require regular blood tests or changing doses often. It can be expensive and there's no way to reverse the medication's effects.
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Reviews & ratings
Button Group. All currently active
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5.146484375Coumadin
Reviews for Coumadin (Warfarin)
61%
of people say Coumadin (Warfarin) is worth it
54%
say it works well
21%
say it's a big hassle

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Side effects
CoumadinXarelto

The Coumadin FDA package insert doesn’t have numbers about how common side effects are.

More about Coumadin side effects »
  • Back pain 3%
More Xarelto side effects »
How it works
CoumadinXarelto
Coumadin (Warfarin) is an anticoagulant blood thinner. It lowers chemicals called clotting factors so that it's harder for your body to form blood clots.Xarelto (Rivaroxaban) is an anticoagulant that stops the formation of blood clots.
Type of medication
CoumadinXarelto
Anticoagulant
Vitamin K antagonist
Prescription only
Anticoagulant
Factor Xa inhibitor
Prescription only
Available as
CoumadinXarelto
  • Pill
  • Pill
Used for (click to learn more)
CoumadinXarelto
Risk factors for serious side effects
CoumadinXarelto
  • Dose too high
  • Age greater than 65
  • History of gastrointestinal bleeding
  • High blood pressure
  • Kidney or liver problems
  • Drug interactions
  • Change in lifestyle or diet
  • Illnesses
  • Alcohol
  • Certain genetic makeup
    • Women of childbearing age
    Detailed Coumadin (Warfarin) risks & warnings »
    • Stopping Xarelto (Rivaroxaban) too soon
    • Artificial heart valve
    • Spinal puncture (spinal tap)
    • Getting anesthesia in the spine (epidural anesthesia)
    • History of bleeding problems
    • Severe high blood pressure
    • Age 65 or older
    • Drug interactions
    • Taking NSAIDs, aspirin, or other blood-thinning medicines
    • Current kidney problems
    • Current liver problems
    Detailed Xarelto (Rivaroxaban) risks & warnings »
    Pregnancy category
    CoumadinXarelto
    XFDA pregnancy category (Unsafe)

    Research studies with real people or animals found harmful effects on unborn babies. If you’re pregnant, the risks to your unborn baby outweigh the benefits.

    See the FDA package insert
    CFDA pregnancy category (Weigh risks vs. benefits)

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    See the FDA package insert
    Alcohol
    • Many lifestyle factors can affect how well warfarin works, such as diet, alcohol, and activity level, so it's important that you try to stay consistent with your behaviors.
    No specific alcohol-related info.
    Food
    • Eat foods containing consistent amounts of Vitamin K.
    • Xarelto (Rivaroxaban) doesn't have as many food interactions as compared to other anticoagulants like warfarin (Coumadin).
    • Take Xarelto (Rivaroxaban) with food and a full glass of water.
    Kidneys and liver
    No specific kidneys and liver-related info.
    • Xarelto (Rivaroxaban) is processed by the kidney and liver. If you have kidney or liver problems, talk to your doctor about possibly switching to a different medicine to prevent increased risk for side effects.
    Sex
    No specific sex-related info.No specific sex-related info.
    Sleep
    No specific sleep-related info.No specific sleep-related info.
    Weight
    No specific weight-related info.No specific weight-related info.
    Upsides and benefits
    CoumadinXarelto
    • Oral blood-thinning medicine that prevents blood clots from forming or getting bigger.
    • Prevents complications of blood clots that can cause extreme discomfort or death. Examples include stroke (blood clots in the brain), pulmonary embolism (blood clots in the lungs causing trouble breathing), or deep vein thrombosis (blood clots in the legs causing pain and blood vessel damage).
    • Has an antidote, Vitamin K, in case of a major accidental bleeding.
    • Coumadin (Warfarin) has been around for a long time, so we know a lot about how well it works and what the risks are.
    • It's dirt cheap.
    • Studies have shown that Xarelto (Rivaroxaban) works just as well as other blood thinners (anticoagulants) in preventing strokes and reducing bleeding.
    • Xarelto (Rivaroxaban) doesn't require regular blood testing or frequent dose adjustments.
    • Xarelto (Rivaroxaban) doesn't have as many food interactions as compared to other anticoagulants like warfarin (Coumadin).
    Downsides and risks
    CoumadinXarelto
    • Raises your risk of bleeding and bruising.
    • Requires routine blood testing (called an INR) to see how well the medicine is working for you and to make the dose just right for you.
    • Many lifestyle factors can affect how well warfarin works, such as diet, alcohol, and activity level, so it's important that you try to stay consistent with your behaviors.
    • Lots of interactions with other drugs or supplements. Always check with your doctor or pharmacist before starting any new meds.
    • Xarelto (Rivaroxaban) can increase your risk of bleeding. Call your doctor right away if there is blood in your phlegm, urine, or stool (look for black, tarry stools).
    • Xarelto (Rivaroxaban) isn't available as a generic medication.
    • There are no antidotes to stop bleeding caused by taking too much Xarelto (Rivaroxaban).
    • Can't take during pregnancy.
    Tips from our pharmacists for people taking the medication
    CoumadinXarelto
    • Thins your blood to prevent clots from forming or getting bigger. Doesn't break up existing clots.
    • The amount you need depends on your diet, other medical problems, and genes.
    • Take it exactly as instructed.
    • Can raise your risk of bleeding or bruising.
    • Requires regular blood tests to get your dose right.
    • Interacts with a lot of medicines and supplements. Don't start any new meds without talking to your doctor.
    • Eat foods containing consistent amounts of Vitamin K.
    • Tell your doctor immediately if you fell or if you have unusual bleeding, bruising, swelling, or changes in vision and coordination.
    • Get a medical bracelet so that people know you're on a blood thinner during an emergency situation.
    • Xarelto (Rivaroxaban) is an anticoagulant, so it's important not to miss a dose. Don't stop taking this medication without talking to your doctor first.
    • When taking Xarelto (Rivaroxaban), you can bleed more easily, so use a soft toothbrush and an electric razor to avoid cutting yourself.
    • Take Xarelto (Rivaroxaban) with food and a full glass of water.
    • You can crush the tablets and mix with applesauce.
    Learn more
    More about CoumadinSide effectsReviews & ratingsAlternativesFDA package insert
    More about XareltoSide effectsReviews & ratingsAlternativesFDA package insert