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 a cheap and effective medicine that prevents new blood clots. It requires regular blood tests and you'll need to eat, exercise, and take your medicines consistently.Prevents blood clots. Xarelto (rivaroxaban) is a good medication for preventing blood clots. It doesn't require regular blood tests or changing doses often. However, it can be expensive and there's no way to reverse the medication's effects.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.15Coumadin
Reviews for Coumadin
61%
of people (All ages) say Coumadin is worth it
54%
say it works well
21%
say it's a big hassle
513 reviews
Have you used Coumadin (warfarin)?
Worth itNot sureNot worth it
Reviews for Xarelto
45%
+16% better vs. Coumadin
45%
+9% better vs. Coumadin
9%
-12% worse vs. Coumadin
Have you used Xarelto (rivaroxaban)?
Worth itNot sureNot worth it
Side effects
CoumadinXarelto

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

More about Coumadin side effects »
  • Major bleeding needing transfusion 4%
  • Bleeding in the stomach & intestines 2%
  • Complaints of bleeding 28%
  • Clinically relevant but not major bleeding 9%
  • Back pain 3%
  • Upper abdominal pain 2%
  • Joint arthritis 1%
  • Any bleeding event after hip or knee replacement surgery 6%
  • Any side effect causing stopping of xarelto (rivaroxaban) 4%
  • Wound drainage 3%
More Xarelto side effects »
How it works
CoumadinXarelto
Coumadin (warfarin) prevents blood clots from forming. It doesn't break up clots that already exist. It can only stop new ones from forming or old ones from getting bigger.Xarelto (rivaroxaban) is an anticoagulant that stops blood clots from forming.
Type of medication
CoumadinXarelto
Prescription onlyPrescription only
Available as
CoumadinXarelto
  • Pill
  • Pill
Used for
CoumadinXarelto
Risk factors for serious side effects
CoumadinXarelto
  • Coumadin (warfarin) dose too high
  • Age greater than 65 year
  • History of stomach bleeding
  • High blood pressure
  • Kidney or liver problems
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
Detailed Xarelto (rivaroxaban) risks & warnings »
Pregnancy

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.

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.

Interactions
CoumadinXarelto
  • Coumadin (warfarin) interacts with many drugs and supplements. This can increase your risk of bleeding or of developing a new blood clot. If you start a new medication or change your diet, let your doctor know so they can change your dose if necessary.
  • A lot of other drugs and supplements interact with Coumadin (warfarin), so you'll need to check with your doctor or pharmacist before starting any new medicines.
  • Xarelto (rivaroxaban) doesn't interact with as many types of food as other blood thinners like warfarin (Coumadin).
Food
CoumadinXarelto
No food related info.
  • Like all blood thinners, it will take a little longer for your blood to clot if you start bleeding while you're taking Xarelto (rivaroxaban). Call your doctor if you notice bleeding that won't stop, a bruise that won't go away or gets worse, pink or brown urine, bright red or dark tarry stool, nose bleeds, or if you start coughing up blood.
Kidneys and liver
CoumadinXarelto
No 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 avoid other side effects.
Upsides and benefits
CoumadinXarelto
  • Coumadin (warfarin) is available as a generic, so it should be less expensive than the brand version.
  • In case you start bleeding too much while using Coumadin (warfarin), your doctor can give you another drug that reverses Coumadin (warfarin)'s effects.
  • Coumadin (warfarin) comes in numerous strengths.
  • Coumadin (warfarin) has been around for a long time and is one of the most commonly used 'blood thinner' medicines.
  • Studies show that Xarelto (rivaroxaban) works just as well as other blood thinners (anticoagulants) in preventing strokes and stopping clots from froming.
  • Xarelto (rivaroxaban) doesn't require regular blood tests or frequent dose changes.
  • Xarelto (rivaroxaban) doesn't interact with as many types of food as other blood thinners like warfarin (Coumadin).
Downsides and risks
CoumadinXarelto
  • Raises your risk of bleeding and bruising.
  • Requires regular blood work, such as an INR, to make sure Coumadin (warfarin) is working correctly.
  • Your daily dose of Coumadin (warfarin) can change if you change your diet, exercise patterns, or use of alcohol.
  • A lot of other drugs and supplements interact with Coumadin (warfarin), so you'll need to check with your doctor or pharmacist before starting any new medicines.
  • Xarelto (rivaroxaban) can increase your risk of bleeding, so call your doctor right away if you see blood in your spit, urine, or stool (look for black, tarry stools or bright red blood).
  • Xarelto (rivaroxaban) isn't available as a generic medication.
  • There are no antidotes to stop bleeding caused by taking too much Xarelto (rivaroxaban).
  • You can't take Xarelto (rivaroxaban) if you are pregnant.
Tips from our pharmacists for people taking the medication
CoumadinXarelto
  • Prevents clots from forming or getting bigger. It doesn't break up clots that already exist.
  • Take Coumadin (warfarin) exactly as your doctor tells you.
  • Once you're taking Coumadin (warfarin), it'll take longer for your body to heal if you get cut or bruised. Call your doctor if you notice any unusual bleeding or bruising.
  • Carry a list of your medications with you or wear a medical bracelet that says you're on Coumadin (warfarin) in case you have a medical emergency.
  • Your doctor will check your blood regularly for the first few months that you're taking Coumadin (warfarin).
  • To get the best results, don't fall behind on taking your other medicines and eat the same amount of vegetables each day.
  • Xarelto (rivaroxaban) prevents blood from clotting, so it's important not to miss a dose. If you miss your daily dose, take it as soon as you remember that day. Just don't take two doses close to each other.
  • If you completely forget to take a dose, call your doctor right away.
  • When taking Xarelto (rivaroxaban), you can bleed more easily, so use a soft toothbrush and an electric razor to avoid cutting yourself.
  • You can crush the pills and mix it with a spoonful of applesauce, but make sure to eat some food and drink a glass of water right away.
Learn more
More about CoumadinSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Coumadin (warfarin)?
Worth itNot sureNot worth it
More about XareltoSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Xarelto (rivaroxaban)?
Worth itNot sureNot worth it