Pradaxa vs. Xarelto: Know the Difference

Pradaxa vs. Xarelto: Know the Difference

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: October 17, 2023


When it comes to health, it’s essential to stay informed, especially if you or a loved one is dealing with a condition like atrial fibrillation. Pradaxa and Xarelto are two medications used to treat this condition.

A-fib, as it’s often called, is a heart rhythm disorder that can increase the risk of blood clots, strokes, and other serious complications.

When atrial fibrillation occurs, the heart’s upper chambers (the atria) don’t beat regularly.

Instead, they quiver or flutter, which can make the heart beat too fast or irregularly. This can lead to problems like feeling tired, short of breath, or dizzy.

A-Fib can also increase the risk of stroke because blood can gather in the atria and form clots that may travel to the brain.

Managing atrial fibrillation might mean taking medications like Pradaxa or Xarelto, and working closely with your doctor to find the best way to keep your heart healthy and your lifestyle as normal as possible.

Not only can these two medications help treat Afib, but either drug can also be used as a deep vein thrombosis (DVT) treatment and as a stroke prevention medication.

This article will dive into the treatment of atrial fibrillation and explore how Pradaxa and Xarelto stack up against each other.

We’ll break down the similarities and differences between these two medications, giving you the information you need to make an informed decision about your treatment.

Your health matters, and we’re here to help you navigate the choices available, providing 

insights into their effectiveness, potential adverse effects, and more. Let’s get started!

Xarelto vs. Pradaxa: How do they work?

To make an informed choice between Xarelto and Pradaxa, it’s crucial to understand how these medications work in the body and how they address atrial fibrillation.

About Pradaxa

Pradaxa is a direct thrombin inhibitor. Thrombin is an enzyme involved in the formation of blood clots.

It works by blocking thrombin and prevents the formation of clots. Doing so reduces the risk of strokes and systemic embolism in patients with atrial fibrillation.

About Xarelto

Xarelto belongs to the direct oral anticoagulants (DOACs) class and specifically targets factor Xa, another vital part of the process that thickens your blood and forms clots. Factor Xa is like the first domino that starts a chain reaction leading to the creation of thrombin, which makes clots.

Xarelto stops this domino effect, so there’s less chance of dangerous blood clots forming in people with atrial fibrillation.

How do these medications compare?

Although belonging to different classes of medications, Pradaxa and Xarelto have the same goal: to prevent blood clots in people with atrial fibrillation.

One key difference is how they stop the blood from thickening. Pradaxa directly tells the main clot-forming enzyme, thrombin, to stop working.

On the other hand, Xarelto blocks a different step in the process, making it harder for clots to form.

The choice between them often depends on factors like a patient’s medical history and what their doctor thinks will work best for them. Your doctor can help you decide which one is right for you.

Xarelto vs. Pradaxa: Which medication works better?

Now, let’s talk about the most critical aspect: how well Pradaxa and Xarelto do their job in preventing strokes and other complications caused by atrial fibrillation.

Studies have shown that Pradaxa effectively reduces the risk of strokes and systemic embolism in people with atrial fibrillation.

Studies have shown that Pradaxa is as effective as the older warfarin medication. Many doctors and patients now trust Pradaxa as a preferred choice.

Xarelto has also demonstrated its effectiveness in multiple studies. It is as effective as Warfarin in preventing strokes and reducing the risk of blood clots for people with atrial fibrillation.

When comparing Xarelto vs. Pradaxa, it’s important to note that both medicines lessen the risk of strokes and blood clots in those with atrial fibrillation. There have been no studies to directly compare these drugs to each other.

In addition, Pradaxa and Xarelto both fall into the class of Direct Oral Anticoagulants (DOACs). DOACs are stroke prevention medications widely used over medications like Warfarin because there is a smaller chance of bleeding, and they tend to work better at preventing blood clots.

Which one is right for you?

The choice between the two may come down to personal preferences, cost, and any specific health considerations you have. Your healthcare provider will carefully assess your needs and medical history to determine the best fit for you.

So, whether you and your doctor choose Pradaxa or Xarelto, both medications have shown their ability to help protect your heart health and reduce the risk of severe complications from atrial fibrillation.

Always make sure to follow your doctor’s advice and take your medicine exactly as prescribed to get the most benefit from it. Your well-being is what matters most.

Dosage and administration comparison

Taking your medications as prescribed is crucial to ensure they work as effectively as possible. Let’s break down how to take Pradaxa vs. Xarelto.

Pradaxa administration and dosing

Pradaxa (dabigatran) is usually taken twice a day with a meal. This helps your body absorb the medicine properly and keeps it working consistently to prevent blood clots.

The typical dosage for Pradaxa is 150 milligrams (mg) taken twice a day. Remember to follow your doctor’s instructions carefully and not miss any doses.

Xarelto administration and dosing

Xarelto (Rivaroxaban) is usually taken once daily with a meal. This once-daily dosing can be more convenient for some people who prefer to take only one dose throughout the day.

The average dosage is 20 mg once a day. However, just like with Pradaxa, your doctor might change the dose if it’s better for your health.

Which is better?

One advantage of Xarelto is its once-daily regimen, which can be easier to manage when it comes to dosing and administration.

The choice between the two often depends on your personal preference and lifestyle.

Both medications are effective when taken as directed, so discussing your needs and habits with your healthcare professional can help you decide which medication is right for you.

Adverse effects of Pradaxa and Xarelto

Knowing what kind of adverse effects might come with Pradaxa and Xarelto is essential so you can be prepared.

Pradaxa adverse reactions

Some common adverse effects with Pradaxa include:

  • Stomach upset
  • Stomach pain
  • Indigestion
  • Bruising or bleeding more than usual

Some rare but serious adverse reactions to Praxada include:

  • Allergic reactions such as itching, rash, and swelling of the face and tongue
  • Heavy bleeding
  • Stroke
  • Blood clot

Xarelto adverse reactions

With Xarelto, common adverse effects are:

  • Stomach ache
  • Nausea
  • Back pain
  • Headache
  • Increased bleeding

Some rare but serious reactions to Xarelto:

  • Fainting
  • Pain in the arms or legs
  • Difficult or painful urination

Comparing adverse effects

When comparing the adverse effects of Pradaxa vs. Xarelto, it’s important to note that both medications have similarities, such as stomach discomfort and digestive issues. It is also beneficial to remember that there is also a bleeding risk with anticoagulants. However, there are vital differences worth considering.

Pradaxa may lead to symptoms like stomach upset, abdominal pain, and indigestion. Some individuals may experience bruising or increased bleeding tendencies, particularly in the gastrointestinal tract.

In terms of tolerability, individual responses vary, and what might be more tolerable for one person may differ for another.

Your healthcare provider will consider your specific health needs and potential side effects when selecting the most suitable medication.

Communicating any side effects or concerns with your healthcare team to ensure your safety and well-being while managing your condition is essential.


Understanding how medications can interact with each other is crucial for your safety. Let’s explore potential interactions for both Pradaxa and Xarelto.


Pradaxa can interact with certain medications, such as antifungal drugs, HIV medications, and some antibiotics. It can also have a severe adverse interaction with aspirin.

These interactions may also affect how Pradaxa works in your body.


Xarelto may interact with some medicines like antiplatelet drugs, anticoagulant medications (blood thinners), and certain pain relievers such as aspirin, naproxen, and ibuprofen.

It’s essential to tell your healthcare provider about all your medications and supplements, including over-the-counter drugs, vitamins, and herbal products.

Healthcare professionals can evaluate the potential interactions and make necessary adjustments to your treatment plan to minimize risks.

Both Pradaxa and Xarelto have the potential for interactions with various drugs. While the specific interactions may differ between the two medications, neither is significantly more or less prone to interactions.

Your healthcare provider is your best resource for managing these interactions and ensuring safety. They will carefully review your medication list, consider your medical history, and make necessary adjustments to minimize the risk of harmful interactions.

Being completely honest with your healthcare team is essential to manage your medications effectively and avoid potential complications. Your well-being is always their top priority.

Cost and availability

The average cost for Pradaxa can vary based on several factors, such as insurance coverage, treatment plan, and pharmacy.

Pradaxa comes in a generic capsule form called dabigatran. However, no generic version is available for the Pradaxa oral medication. It’s a good idea to discuss with your healthcare provider which form they recommend for you to take.

There is currently no generic form of Xarelto, but the manufacturer offers patient assistance programs to help cover out-of-pocket costs.

Pradaxa vs. Xarelto: Making the right decision

Both Xarelto and Pradaxa help individuals with atrial fibrillation manage their condition.

We’ve covered a lot of ground, from how these medicines work and their effectiveness to potential side effects, interactions, and cost considerations.

When choosing between Pradaxa and Xarelto, there’s no one-size-fits-all answer. Each person’s medical journey is unique.

That’s why having a heart-to-heart with your healthcare provider is crucial. They have the knowledge and expertise to evaluate your health needs, discuss your preferences, and guide you toward the most suitable option.

Remember, your well-being is paramount; making an informed decision can significantly impact your heart health.

The right choice begins with a conversation – so go ahead and start that essential dialogue. Your heart will thank you for it.

  1. Cleveland Clinic. Dabigatran Oral Capsules (Pradaxa). 2023. Available at
  2. Pradaxa Interactions. August 28, 2023. Available at
  3. Healthline. Xarelto Interactions: Alcohol, Medications, and Others. August 20, 2022. Available at
  4. Medline Plus. Dabigatran. August 15, 2021. Available at
  5. Mayo Clinic. Rivaroxaban (Oral Route). September 1, 2023. Available at
  6. Medical News Today. Xarelto. October 14, 2022. Available at
  7. Medical News Today. Pradaxa and Dosing. July 11, 2023. Available at
  8. North American Thrombosis Forum. Dabigatran (Pradaxa®): A Deep Dive. July 21, 2022. Available at
  9. Xarelto. Xarelto Dosing Guide. September 2018. Available at
  10. Xarelto Official Patient Website. Important Safety Information. November 2022. Available at
Call Now Button