Coumadin vs Xarelto

Side-by-side comparison of Coumadin and Xarelto — mechanism, indications, safety, trials, sponsor, and pricing.

At a glance

CoumadinXarelto
Generic namewarfarinXarelto
SponsorGeneric (originally Wisconsin Alumni Research Foundation)University Hospital, Montpellier
Drug classVitamin K antagonist (anticoagulant)—
Molecular targetVitamin K epoxide reductase complex subunit 1-like protein 1, Cytochrome P450 2C9, Proprotein convertase subtilisin/kexin type 7Suppressor of tumorigenicity 14 protein, Coagulation factor X, Coagulation factor X
ModalitySmall moleculeSmall molecule
PhaseFDA-approvedFDA-approved
Therapeutic areaCardiovascularOncology
First approval1954-01-01—

Mechanism of action

CoumadinInhibits vitamin K epoxide reductase, blocking the synthesis of vitamin K-dependent clotting factors (II, VII, IX, X) to prevent thrombosis.
Xarelto—

Approved indications

Coumadin

  • Cerebral embolism
  • Deep Vein Thrombosis with Pulmonary Embolism
  • Deep venous thrombosis
  • Myocardial Reinfarction Prevention
  • Prevention of Thromboembolism with Chronic Atrial Fibrillation
  • Prevention of deep vein thrombosis
  • Pulmonary Thromboembolism Prevention
  • Pulmonary thromboembolism

Xarelto

  • Deep venous thrombosis
  • Nonvalvular atrial fibrillation
  • Peripheral arterial disease
  • Prevention of atherothrombotic events after an acute coronary syndrome
  • Prevention of atherothrombotic events at high risk of ischaemic events
  • Prevention of atherothrombotic events in symptomatic peripheral artery disease
  • Prevention of deep vein thrombosis
  • Prevention of pulmonary embolism

Common side effects

Coumadin

  • Hemorrhage
  • Nausea
  • Vomiting
  • Diarrhea
  • Rash
  • Abdominal pain
  • Pruritus
  • Dermatitis

Xarelto

None on file.

Boxed warnings

Coumadin

  • WARNING: BLEEDING RISK Warfarin sodium can cause major or fatal bleeding [see Warnings and Precautions ( 5.1 )] . Perform regular monitoring of INR in all treated patients [see Dosage and Administration ( 2.1 )] . Drugs, dietary changes, and other factors affect INR levels achieved with warfarin sodium therapy [see Drug Interactions ( 7 )] . Instruct patients about prevention measures to minimize risk of bleeding and to report signs and symptoms of bleeding [see Patient Counseling Information ( 17 )] . WARNING: BLEEDING RISK See full prescribing information for complete boxed warning. Warfarin sodium can cause major or fatal bleeding. ( 5.1 ) Perform regular monitoring of INR in all treated patients. ( 2.1 ) Drugs, dietary changes, and other factors affect INR levels achieved with warfarin sodium therapy. ( 7 ) Instruct patients about prevention measures to minimize risk of bleeding and to report signs and symptoms of bleeding. ( 17 )

Xarelto

No boxed warnings.

Further reading