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Pradaxa vs Eliquis

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation
  • For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days
  • To reduce the risk of recurrence of DVT and PE in patients who have been previously treated
  • For the prophylaxis of DVT and PE in patients who have undergone hip replacement surgery
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  • To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
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Summary

Brand name: Pradaxa
Brand name: Eliquis
Manufacturer: Boehringer Ingelheim Pharmaceuticals, Inc.
Manufacturer: Pfizer
Active ingredient: dabigatran
Active ingredient: apixaban
Indication: To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days To reduce the risk of recurrence of DVT and PE in patients who have been previously treated For the prophylaxis of DVT and PE in patients who have undergone hip replacement surgery 
Indication: To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation

Side Effects

Most common

  • Indigestion
  • Diarrhea
  • Feeling sick (nausea)
  • Stomach pain
  • Bruising more often
  • Bleeding more often, including from your gums, nose, genitals, or from your stomach and bowels

More serious

  • Severe allergic reactions to the medication
  • An increased risk of bleeding, including serious bleeding that could be fatal
  • An increased risk of spinal or epidural blood clots (hematoma) forming if you have any injections into your spine or epidural area, or have a spinal puncture. These can cause long-term or permanent paralysis

Most common

  • Increased bleeding, as the medication prevents clotting
  • Anemia
  • Increased bruising
  • Blood in your urine and feces
  • Bleeding from your orifices, like your anus or vagina

More serious

  • Serious, potentially fatal bleeding

Drug Interactions

Severe interaction
  • Antifungal medicine – ketoconazole, itraconazole
  • NSAIDs (Non-steroidal anti-inflammatory drugs) – ibuprofen, naproxen
  • Blood thinners – aspirin, heparin, warfarin
  • Treatments for seizures – carbamazepine, phenytoin
  • St. John’s wort
Serious interaction
  • Any selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants 
  • Antiarrhythmics – amiodarone
Moderate interaction
  • Certain statins – atorvastatin
  • Antibacterials – clarithromycin
Severe interaction
  • Antifungal medicine – ketoconazole, itraconazole
  • NSAIDs (Non-steroidal anti-inflammatory drugs) – ibuprofen, naproxen
  • Blood thinners – aspirin, heparin, warfarin
  • Treatments for seizures – carbamazepine, phenytoin
  • St. John’s wort
Serious interaction
  • Any selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants 
  • Antiarrhythmics – amiodarone, dronedarone
Moderate interaction
  • Treatments for excessive sleepiness – modafinil, armodafinil

Warnings

You should not use Pradaxa if you:

  • Are allergic to the active ingredient dabigatran etexilate mesylate
  • Are allergic to any of the other ingredients in Pradaxa
  • Have ever had a valve in your heart replaced, or are scheduled to have one replaced
  • Are currently bleeding
  • Have any condition which increases your risk of bleeding
  • Have a severe kidney problem
  • Have a severe liver problem
  • Are under 18 years of age

You should talk to your doctor before using Pradaxa if you:

  • Are taking any of the medications that could interact with Pradaxa
  • Have recently been bleeding
  • Have any kidney problems
  • Have any liver problems
  • Have ever had a stomach ulcer
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed
  • Are over 65 years of age

You should not use Eliquis if you:

  • Are allergic to the active ingredient apixaban
  • Are allergic to any of the other ingredients found in Eliquis (listed in the leaflet which comes with the medication)
  • Have artificial heart valves
  • Have antiphospholipid syndrome (APS), especially with positive triple antibody testing, and have a history of blood clots
  • Are under 18 years of age
  • Are bleeding excessively
  • Have an organ condition that increases the likelihood of serious internal bleeding, like a stomach ulcer

You should talk to your doctor before using Eliquis if you:

  • Have an increased risk of bleeding, such as a bleeding disorder or very high blood pressure
  • Are over 75 years of age
  • Weigh 60kg or less
  • Have severe kidney disease or are on dialysis
  • Have a liver problem or a history of liver problems
  • Had a catheter or an injection into your spine
  • Have antiphospholipid syndrome
  • Are lactose intolerant
  • Need to have surgery or another procedure that can cause bleeding

Dosage

Once or twice daily

Twice daily

Cost

60, 75 mg Pradaxa capsules will cost around $530

60, 5 mg Eliquis tablets will cost around $500

FAQs

Pradaxa and Eliquis are FDA-approved medications known as direct oral anticoagulants (DOACs), non-vitamin K antagonist oral anticoagulants (NOACS), or blood-thinning drugs. Clinical trials have shown these drugs are faster acting than vitamin K antagonists like warfarin (Coumadin), are more predictable, meaning you may not need to have blood tests, and have a lower risk of bleeding side effects.

2019 guidelines from the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society recommend DOACs as a treatment option for atrial fibrillation patients and stroke prevention. Other available medications in this category include rivaroxaban (Xarelto) and edoxaban (Savaysa), but here we will focus on the similarities and differences between Pradaxa and Eliquis. Read on to learn more.

What is Pradaxa?

Pradaxa is a blood thinner medication prescribed to adults to lower the chance of blood clots forming. Specifically, it is used to:

  • Lower the risk of stroke (systemic embolism) and blood clots in people who have a medical condition called atrial fibrillation (Afib)
  • To treat and prevent blood clots forming in veins in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
  • To help lower the risk of blood clots forming in veins in the legs (deep vein thrombosis) or lungs (pulmonary embolism) of people who’ve had hip replacement surgery

Pradaxa can be taken to treat existing blood clots and to reduce the chances of blood clots forming. It works by interrupting a step in the blood clotting process. Pradaxa is not for use in people with artificial heart valves.

How does Pradaxa work?

The active ingredient in Pradaxa is called dabigatran etexilate mesylate, usually just called dabigatran. Blood normally clots through a complex chemical reaction with multiple steps. Some of the steps of this reaction use enzymes to help change your blood from a liquid to a gel. One of these enzymes is called thrombin. Dabigatran works by blocking thrombin. When you swallow Pradaxa, molecules of dabigatran are absorbed in your blood, where they bind to thrombin preventing it from working.

How do you take Pradaxa?

Pradaxa is available in capsule form, in the following doses: 75mg, 110mg, and 150mg.

Take Pradaxa capsules orally exactly as prescribed by your healthcare provider.

What is Eliquis?

Eliquis is an anticoagulant, a type of drug that stops blood clotting (turning from a liquid to a thick gel). Eliquis is used to prevent blood clots from forming in people who have:

  • Nonvalvular atrial fibrillation (heart arrhythmia not caused by a heart valve problem) and who have other clotting risk factors
  • Had hip or knee replacement surgery

It’s also used to treat blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism), and to stop blood clots from reoccurring in these places.

How does Eliquis work?

The active ingredient in Eliquis is an anticoagulant called apixaban. As blood clots, it goes through a process of chemical reactions that turns it from a liquid into a thick gel. An enzyme called factor Xa is an important part of this process. Eliquis targets this enzyme. The active ingredient apixaban attaches to factor Xa to stop it from working, reducing the likelihood of blood clots forming.

How do you take Eliquis?

Eliquis is available in tablet form, in the following doses: 2.5 mg and 5 mg.

The recommended dose of Eliquis is 5 mg orally twice daily. Always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition.

Pradaxa and Eliquis and bleeding

Your blood forms clots to plug cuts and injuries, stopping you from bleeding. Because Pradaxa and Eliquis reduce blood clots, they can both put you at a higher risk of bleeding. The bleeding can be serious, even fatal. You may also bruise more easily.

You should avoid other medications that increase your chances of bleeding. These include aspirin and other antiplatelet agents, as well as other anticoagulants, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

The increased risk of bleeding may on occasion turn into a risk of major bleeding, causing life-threatening issues. Inform your doctor if you are taking Pradaxa or Eliquis before you have any medical or dental procedures or surgery. If you are taking Pradaxa or Eliquis and you begin to bleed, or you experience symptoms of blood loss, seek urgent medical attention.

Common side effects of Pradaxa and Eliquis

The most common side effects are related to bleeding for both Pradaxa and Eliquis, these include:

  • Nosebleeds
  • Bleeding gums
  • Heavier menstrual bleeding
  • Unexpected vaginal bleeding
  • Bruising

Pradaxa side effects

  • Nausea
  • Abdominal or stomach pain
  • Indigestion
  • Heartburn
  • Diarrhea

Eliquis side effects

  • Swelling or joint pain
  • Headache
  • Rash
  • Chest pain or tightness
  • Dizziness

Pradaxa may cause more gastrointestinal side effects than Eliquis.

This is not a comprehensive list of all the side effects Pradaxa and Eliquis can cause. Side effects will depend on the dose you are taking and the condition you are being treated for. You can find more details on side effects in the patient leaflet that comes with your medication. If you have any concerns about Pradaxa or Eliquis side effects, talk to your physician or a pharmacist. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1‑800‑FDA‑1088.

Make sure you tell your prescribing physician about all medications you’re taking, including supplements and over-the-counter meds to prevent any drug interactions. You should also inform your healthcare provider of all medical conditions you may have. In particular, asthma, diabetes, heart disease, hypertension, and any kidney problems.

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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