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Key takeaways
Xarelto is a direct oral anticoagulant (DOAC) used to treat and prevent blood clots, but some people may need alternatives due to cost, side effects, or other factors.
Common prescription alternatives to Xarelto include Eliquis, warfarin, Pradaxa, Plavix, and Brilinta—each with different mechanisms, side effects, and monitoring needs.
Only the 2.5 mg dose of Xarelto is available as a generic, making it a cost-saving option—but only for patients using that dose for CAD or PAD.
Xarelto is a brand-name prescription drug that contains the active ingredient rivaroxaban. Xarelto is a direct oral anticoagulant (DOAC)—a newer blood thinner—used to treat and prevent blood clots in the legs (deep vein thrombosis or DVT) and lungs (pulmonary embolism or PE). It’s also used to prevent stroke in people with atrial fibrillation (AFib) not caused by a heart valve problem, and to reduce the risk of major cardiovascular events in people with coronary artery disease (CAD) or peripheral artery disease (PAD). Xarelto is also used to reduce the risk of DVT after hip or knee replacement surgery. In some cases, you may be interested in seeking an alternative to Xarelto—whether due to price, side effects, or other reasons. The good news is that there are various options you can discuss with your healthcare provider.
What can I take instead of Xarelto?
There are various anticoagulant drugs similar to Xarelto. These medications may have different FDA-approved uses, possible side effects, and dosages, which are highlighted in the table below. Another option may be more suitable for someone looking for a Xarelto alternative.
Compare Xarelto alternatives |
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|---|---|---|---|
| Drug name | Price without insurance | SingleCare price | Savings options |
| Xarelto (rivaroxaban) | $821 for 60, 2.5 mg tablets | $193 for 60, 2.5 mg tablets of generic rivaroxaban (note: only the 2.5 mg dose is available in generic) | See latest prices |
| Eliquis (apixaban) | $803 for 60, 5 mg tablets | $488 for 60, 5 mg tablets of brand-name Eliquis | See latest prices |
| Warfarin | $27 for 30, 5 mg tablets | $4 for 30, 5 mg tablets of generic warfarin | See latest prices |
| Pradaxa (dabigatran) | $568 for 60, 150 mg capsules | $91 for 60, 150 mg capsules of generic dabigatran | See latest prices |
| Plavix (clopidogrel) | $666 for 30, 75 mg tablets | $4 for 30, 75 mg tablets of generic clopidogrel | See latest prices |
| Brilinta (ticagrelor) | $637 for 60, 90 mg tablets | $31 for 60, 90 mg tablets of generic ticagrelor | See latest prices |
| Effient (prasugrel) | $711 for 30, 10 mg tablets | $20 for 30, 10 mg tablets of generic prasugrel | See latest prices |
| Savaysa (edoxaban) | $528 for 30, 60 mg tablets | $426 for 30, 60 mg tablets of brand-name Savaysa | See latest prices |
| Arixtra (fondaparinux) | $190 for 10, 2.5 mg syringes | $58 for 10, 2.5 mg syringes of generic fondaparinux | See latest prices |
| Lovenox (enoxaparin) | $242 for 10, 40 mg syringes | $38 for 10, 40 mg syringes of generic enoxaparin | See latest prices |
Top 6 Xarelto alternatives
The following are some of the most common alternatives to Xarelto.
1. Generic Xarelto (rivaroxaban 2.5 mg dose only)
If you are interested in Xarelto generic alternatives, it’s important to note that not all of the available brand-name Xarelto doses have a corresponding generic. Brand-name Xarelto is available in 2.5 mg, 5 mg, 10 mg, and 20 mg tablets, as well as a liquid form. However, only the 2.5 mg tablet is available in generic form. If cost is the reason you are looking for an Xarelto substitute, and you are taking the 2.5 mg dose, filling your prescription for generic Xarelto might be your best option. The 2.5 mg dose is FDA approved (along with aspirin) to prevent stroke and other cardiovascular events in people with coronary artery disease (CAD) or peripheral artery disease (PAD). So, this switch will only apply to certain patients who are taking Xarelto for CAD or PAD.
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2. Eliquis
Eliquis (apixaban) is a direct oral anticoagulant medication that works in the same way as Xarelto by blocking a protein in the body called factor Xa, thereby reducing blood clotting. This newer drug is one of the most popular anticoagulants available to lower the risk of DVT, PE, and stroke in Afib patients. Like all blood thinners, Eliquis can cause bleeding side effects such as nosebleeds and bruising. An antidote to reverse major bleeding is available for both Eliquis and Xarelto. The standard dosage for Eliquis is 2.5 mg or 5 mg twice daily, depending on the indication.
RELATED: Eliquis vs. Xarelto
3. Warfarin
Warfarin (brand names: Coumadin and Jantoven) is the oldest and one of the most commonly used anticoagulants. Warfarin works by blocking the action of vitamin K to stop the blood clotting process. Xarelto and warfarin are both similarly effective at preventing DVT, PE, and stroke, but warfarin requires additional monitoring to measure how well the drug is working. Individuals taking warfarin must undergo regular blood tests to monitor the international normalized ratio (INR), which represents how quickly the blood clots. Based on the INR value, the dose of warfarin may be changed. There are also many medications and foods that interact with warfarin.
RELATED: Eliquis vs. warfarin
4. Pradaxa
Pradaxa (dabigatran) is another anticoagulant like Xarelto, but it works by blocking a different blood-clotting protein called thrombin. Pradaxa and Xarelto are prescribed for similar reasons, and studies have found these two drugs to be similarly effective in preventing stroke in Afib patients. However, Pradaxa was associated with a lower major bleeding risk compared to Xarelto. Other notable side effects of Pradaxa include stomach pain and heartburn. The standard dosage of Pradaxa is 150 mg twice daily.
5. Plavix
Plavix (clopidogrel) is an antiplatelet drug that helps prevent blood clots by preventing platelets from sticking together. Plavix and Xarelto are both used to prevent heart attack and stroke in individuals with heart and vascular diseases, but they work in different ways. Side effects of Plavix and Xarelto are similar and include increased bleeding, itching, and stomach pain. For heart disease, Plavix is usually taken along with aspirin, where Plavix is given at a dosage of 75 mg once daily.
RELATED: Plavix vs. Brilinta
6. Brilinta
Brilinta (ticagrelor) is another antiplatelet medication that is approved by the Food and Drug Administration (FDA) for use in heart disease patients at increased risk of stroke and heart attack. Brilinta and Xarelto both increase the likelihood of bleeding, but Brilinta has an additional side effect of shortness of breath, which occurs in about 14% of people taking the medication. Brilinta is usually prescribed at a dosage of 60 mg or 90 mg twice daily, together with low-dose aspirin.
RELATED: Do Brilinta and caffeine mix?
Natural alternatives to Xarelto
In addition to prescription anticoagulants, there are also certain foods and vitamins that naturally have blood thinning properties. Taking these over-the-counter nutritional supplements along with maintaining a healthy lifestyle may help reduce the risk of blood clots and cardiovascular disease, but they are not a substitute for medications prescribed by your doctor. It is important to speak with a healthcare professional before trying these remedies, as they may interact with some prescription drugs.
Natural blood thinners include the following foods and supplements:
- Garlic: One study found that garlic supplements reduced blood pressure in people with high blood pressure, and also improved arterial stiffness and blood “stickiness,” suggesting that garlic may offer mild anticoagulant effects.
- Turmeric: Turmeric is a golden spice that contains curcumin, a substance with natural blood-thinning and anti-inflammatory properties. One study examining the effects of curcumin concluded that daily consumption of turmeric may help maintain anticoagulant effects and healthy blood flow.
- Ginger: Ginger contains a chemical called salicylate. Salicylate is a natural blood thinner and is also the main component of aspirin.
- Vitamin E: Vitamin E can help prevent blood clot formation by widening blood vessels and blocking platelets from clumping together. Sources of vitamin E include sunflower seeds, almonds, and hazelnuts, as well as dietary supplements.
- Omega-3 fatty acids: High doses of omega-3 fatty acids, found in fish oil, can have anti-clotting effects. Omega-3 fatty acid supplements are available in both over-the-counter and prescription forms.
Natural alternatives are not as effective as anticoagulant drugs and should not be used in place of prescription medications, especially for high-risk patients. When taken in conjunction with other blood thinners, these natural remedies may increase the risk of bleeding, and their use should be monitored by a healthcare professional.
How to switch to a Xarelto alternative
Switching to an alternative for Xarelto may be necessary for some people. Individuals who want to switch to a different anticoagulant should discuss their decision with a healthcare provider and take the following steps:
1. Do not stop taking Xarelto
Suddenly stopping Xarelto can increase the risk of having a stroke, DVT, or PE. Xarelto should not be stopped unless under the medical advice of a cardiologist or other doctor.
RELATED: Is it safe to stop blood thinners before surgery?
2. Keep a journal of symptoms
Keep a record of any new or ongoing symptoms of your condition, including their frequency and intensity. A healthcare provider can evaluate this symptom journal to see how well Xarelto is working and if any changes should be made.
3. Tell the doctor about medication side effects
Let your doctor know about any Xarelto side effects that are bothersome or affect your quality of life. Get immediate medical attention at any sign of serious side effects, which can be life-threatening, such as:
- Unexpected or unusual bleeding
- Bleeding that is severe or unable to be controlled
- Red, pink, or brown urine
- Red or black stools
- Coughing up blood or blood clots
- Vomiting blood or vomit that looks like coffee grounds
- Headaches, dizziness, or weakness
RELATED: What are the side effects of Xarelto in the elderly?
4. Tell the doctor about all medical conditions you have, as well as medications and supplements being taken
Some drugs, herbal remedies, foods, and drinks (like alcohol) can increase the risk of bleeding when taken along with anticoagulants. Talk to your doctor about all the medicines and supplements you’re taking before switching to a Xarelto alternative in order to avoid drug interactions.
- Xarelto, DailyMed (2025)
- Rivaroxaban, DailyMed (2025)
- FDA approves first generics of anticoagulant Xarelto, FDA (2025)
- Eliquis, DailyMed (2025)
- Warfarin, DailyMed (2023)
- Pradaxa, DailyMed (2023)
- Direct comparison of dabigatran, rivaroxaban, and apixaban for effectiveness and safety in nonvalvular atrial fibrillation, Chest (2016)
- Plavix, DailyMed (2024)
- Brilinta, DailyMed (2024)
- Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness and gut microbiota: A review and meta-analysis, Experimental and Therapeutic Medicine (2019)
- Anticoagulant activities of curcumin and its derivative, BMB Reports (2012)
- Vitamin E, National Institutes of Health Office of Dietary Supplements (2021)
- Omega-3 fatty acids, StatPearls (2024)