Your session is about to expire
Aspirin vs Xarelto
Introduction
For patients with cardiovascular disease or a risk of blood clotting, certain drugs that inhibit the formation of clots within the bloodstream can help in reducing risks and managing symptoms. Aspirin and Xarelto are two such drugs that are often prescribed for these conditions. Both impact different mechanisms in the body to prevent blood clotting but serve similar purposes for patients at risk of strokes, heart attacks, or other thromboembolic events. Aspirin is classified as an antiplatelet drug—it works by limiting platelets' ability to form clots by inhibiting their production of thromboxane A2. On the other hand, Xarelto is classified as an anticoagulant—specifically a direct factor Xa inhibitor—which means it prevents blood from coagulating into harmful clots by interfering with one stage in the complex process of clot formation.
What is Aspirin?
Aspirin, also known as acetylsalicylic acid, is a nonsteroidal anti-inflammatory drug (NSAID) that has been in use for many years. It was first approved by the FDA in 1938 and is commonly utilized as a pain reliever, fever reducer, and blood thinner to prevent heart attacks or strokes. Aspirin works by reducing substances in the body that cause pain and inflammation.
On the other hand, Xarelto (generic name Rivaroxaban), which received its initial FDA approval in 2011, belongs to a newer class of anticoagulant drugs called direct factor Xa inhibitors. Like aspirin it can help prevent strokes and systemic embolism but it's specifically used for patients with certain types of arrhythmia (nonvalvular atrial fibrillation). Unlike aspirin’s broad action on clotting mechanisms, Xarelto more selectively inhibits one part of the coagulation cascade. This results in fewer side effects compared to classic anticoagulants like Warfarin because they affect multiple steps within this cascade. However unlike Aspirin which can be stopped abruptly without major risks; if you stop taking Xarelto suddenly you increase your risk of forming clots.
What conditions is Aspirin approved to treat?
Aspirin and Xarelto are both approved for the prevention of different cardiovascular conditions:
- Aspirin is primarily used to prevent heart attacks in people who have had a heart attack or stroke, or who have other heart problems.
- Xarelto, on the other hand, is used to reduce the risk of stroke and blood clots in patients with non-valvular atrial fibrillation. It's also used for treatment and secondary prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE).
How does Aspirin help with these illnesses?
Aspirin helps to manage the risk of heart attacks and strokes by inhibiting platelet aggregation. It does this by irreversibly blocking an enzyme called cyclooxygenase, which plays a crucial role in producing thromboxane A2 – a substance that makes platelets sticky and more likely to clot. Platelets are tiny blood cells that help your body form clots to stop bleeding. If you have too many platelets or they are too sticky, they can form blood clots. These clots can block blood vessels leading to the brain or heart, causing a stroke or heart attack.
On the other hand, Xarelto works differently than aspirin; it's an anticoagulant medication often termed as "blood thinner". Unlike Aspirin which impacts platelet function, Xarelto directly inhibits Factor Xa - a key protein involved in forming clots within our bloodstream.
While both drugs work towards preventing harmful clot formations within our bodies, their modes of action do differ significantly – thereby making them suitable for different conditions and circumstances based on patient-specific factors.
What is Xarelto?
Xarelto, a brand name for rivaroxaban, is an anticoagulant that belongs to the class of drugs known as direct factor Xa inhibitors. It works by blocking the clotting protein factor Xa in blood, thereby decreasing thrombin formation and preventing blood clots. First approved by FDA in 2011, its use has become widespread due to its efficacy and predictable pharmacokinetics.
As compared to aspirin which also prevents the formation of blood clots but does so by inhibiting platelet aggregation, Xarelto's effect on coagulation cascade makes it more suitable for preventing stroke and systemic embolism in patients with nonvalvular atrial fibrillation or following hip or knee replacement surgery.
Unlike aspirin, however, Xarelto can increase bleeding risk significantly especially if taken concomitantly with other medications that also affect coagulation; hence should be used cautiously. Despite this potential side-effect profile difference from Aspirin which usually causes mild gastrointestinal issues like dyspepsia and gastric ulceration at most common dosage levels (unless over-dosed), many patients benefit from using Xarelto when they are at high risk for stroke or venous thromboembolism (VTE) events where aspirin alone may not provide sufficient protection.
What conditions is Xarelto approved to treat?
Xarelto is a widely accepted treatment option for the following conditions:
- Prevention of stroke in people with atrial fibrillation (AF, an irregular heartbeat)
- Treatment and prevention of deep vein thrombosis (DVT, a blood clot in the legs) and pulmonary embolism (PE, a blood clot in the lungs)
- Prevention of venous thromboembolism (VTE, blood clots that start in a vein) in patients who've undergone hip or knee replacement surgery
How does Xarelto help with these illnesses?
Xarelto is an anticoagulant that works by inhibiting one of the key factors responsible for blood clotting in the body, known as Factor Xa. This action prevents thrombin formation and development of blood clots. It's often prescribed to patients with a high risk of stroke or those who have undergone certain types of surgery. Aspirin also has anti-clotting effects but it operates differently, by inhibiting platelets from aggregating together to form a clot. Xarelto specifically targets factor Xa which makes it more effective at preventing specific types of clots like deep vein thrombosis (DVT) and pulmonary embolism (PE), and less likely to cause certain side effects associated with aspirin use such as stomach irritation or bleeding issues. Hence, if a patient requires long-term anticoagulation therapy or doesn't respond well to aspirin, Xarelto may be considered as an alternative.
How effective are both Aspirin and Xarelto?
Both aspirin and rivaroxaban (Xarelto) have established histories of success in preventing blood clots, with aspirin being around for more than a century and rivaroxaban approved by the FDA in 2011. They act on different aspects of the coagulation process, making them useful under different circumstances. The efficacy of both drugs was directly compared in several studies; for example, a large-scale study published in 2018 showed that low-dose rivaroxaban combined with aspirin was significantly more effective at reducing risk of stroke or heart attack than aspirin alone.
A meta-analysis conducted in 2009 demonstrated that long-term, low-dose aspirin therapy is effective at reducing cardiovascular events such as strokes and myocardial infarctions. Aspirin's side effect profile is generally favorable when used within recommended dosages but can include gastrointestinal issues such as ulcers or bleeding, particularly among older adults.
Rivaroxaban has been found to be effective at preventing venous thromboembolism following hip or knee replacement surgery and treating deep vein thrombosis (DVT) or pulmonary embolism (PE), according to numerous clinical trials which formed its basis for approval by regulatory authorities worldwide. Rivaroxaban tends to cause less bleeding than traditional anticoagulants like warfarin but may still pose significant risks especially if taken alongside other medications that increase bleeding risk. Nonetheless, due to its unique mechanism of action - direct inhibition of Factor Xa - it may be an optimal treatment choice for patients who did not respond well to traditional anticoagulants.
At what dose is Aspirin typically prescribed?
Oral dosages of Aspirin for heart disease prevention usually range from 75-325 mg/day, depending on the individual's needs and response to therapy. This medication can be started at lower doses in older adults or people with kidney disease. For Xarelto, typically used as a blood thinner, the standard dosage is 20mg once daily with food for patients with nonvalvular atrial fibrillation; and 15mg twice daily with food for hip or knee replacement surgery. The dosage may be adjusted based on renal function assessment results. The maximum recommended dose per day should not exceed the prescribed amount by your doctor under any circumstances.
Related trials for aspirin and xarelto
Find Top Clinical Trials
Choose from over 30,000 active clinical trials.
At what dose is Xarelto typically prescribed?
Xarelto treatment is most commonly initiated at a dosage of 15 mg taken twice daily for the first 21 days after diagnosis of venous thromboembolism (VTE). Following this, the dose is reduced to 20 mg once daily. For those with atrial fibrillation (AF), the typical starting dose is usually 20 mg per day, depending on kidney function. It's important not to stop taking Xarelto without speaking with your doctor first as this may increase your risk of blood clot or stroke. The efficacy and safety profile should be assessed regularly during treatment.
What are the most common side effects for Aspirin?
Common side effects of Aspirin include:
- Mild indigestion or heartburn
- Nausea and vomiting
- Increased bleeding risk, bruising easily
- Ringing in the ears (tinnitus) and hearing loss
On the other hand, Xarelto may present with these common side effects:
- Bleeding more easily than normal, including from minor cuts or nosebleeds
- Weakness and fatigue
- Back pain
- Itching or rash on your skin
- Swelling in your arms or legs
Are there any potential serious side effects for Aspirin?
While both Aspirin and Xarelto are used to prevent blood clots, they can have different side effects. In rare cases, serious side effects of Xarelto may occur such as:
- Unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections that won't stop.
- Signs of a severe allergic reaction: hives; difficult breathing; swelling in your face or throat.
- Headaches, dizziness, weakness
- Pink or brown urine
- Red or black stools (looks like tar)
- Coughing up blood or vomit that looks like coffee grounds.
In case of Aspirin:
- Ringing in your ears
- Bruising/bleeding easily
- Severe nausea/vomiting/dizziness/fainting/bloody/black/tarry stools/stomach pain
- Yellow eyes/skin
If you experience any unusual symptoms while taking either medication contact medical help immediately.
What are the most common side effects for Xarelto?
Xarelto, an anticoagulant used to prevent blood clots, can have side effects such as:
- Unexpected bleeding or bleeding that lasts a long time
- Headache and dizziness
- Nausea, vomiting, and stomach pain
- Fatigue or weakness in the body
- Swelling of the legs or arms (edema)
- Anemia symptoms like pale skin, feeling tired or short of breath
- Bruising more easily than normal In rare cases, it may cause serious spinal cord complications if you undergo spinal anesthesia while taking Xarelto. Always consult with your healthcare provider about potential risks before starting any new medication.
Are there any potential serious side effects for Xarelto?
While Xarelto is often effective in preventing blood clots, there are potential side effects to be aware of. These can include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Unexpected bleeding or bleeding that lasts a long time (such as frequent nose bleeds, unusual bleeding from the gums, heavier than normal menstrual or vaginal bleeding)
- Red or black stools
- Coughing up blood or vomit that looks like coffee grounds
- Severe headache, dizziness, fainting
- Difficulty with balance and coordination
If you experience any of these symptoms while taking Xarelto it is important to seek immediate medical attention.
Contraindications for Aspirin and Xarelto?
Both Aspirin and Xarelto, along with most other anticoagulant medications, may increase the risk of bleeding in some people. If you notice any unusual bruising or prolonged bleeding after minor cuts or injuries, seek immediate medical attention.
Neither aspirin nor Xarelto should be taken if you are using certain medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) or other anticoagulants. Always inform your physician about all the medication that you’re currently taking; these drugs can interact unfavorably with both aspirin and Xarelto increasing the risk of gastrointestinal bleeds.
Aspirin and Xarelto also require caution when used by individuals with a history of stomach ulcers, liver disease, kidney disease or hemorrhagic stroke. Regular monitoring may be required to ensure safe use.
How much do Aspirin and Xarelto cost?
For the brand name versions of these drugs:
- The price of 100 tablets of Bayer Aspirin (325 mg) averages around $7, which works out to approximately $0.07/day.
- The price of 30 tablets of Xarelto (20 mg) is about $470, working out to an expensive $15.67/day.
Thus, if you are in need for blood thinning medication and aspirin is deemed suitable by your healthcare provider, then it can be a significantly cheaper option than Xarelto on a per-day treatment basis. However, it's crucial to remember that cost should not be the primary consideration when deciding between these two medications - their efficacy and suitability depending on individual health conditions are paramount factors.
For generic versions:
- Acetylsalicylic Acid (Aspirin) is available even at lower costs with approximate daily expenses going as low as just a few cents.
- Rivaroxaban (generic version for Xarelto), however isn't widely available yet due to patent protections but once accessible, it will likely reduce the overall cost considerably.
Popularity of Aspirin and Xarelto
Aspirin, available as both a generic and brand-name drug, has been used for over a century to treat pain, fever, inflammation and to reduce the risk of heart attacks. Its use is widespread, with millions consuming it daily in the US alone.
Rivaroxaban (Xarelto), on the other hand, is relatively new to the market and was approved by FDA in 2011. It's an oral anticoagulant that reduces blood clot formation which decreases stroke risk particularly in patients with nonvalvular atrial fibrillation. In 2020 it was estimated that about 4 million prescriptions were filled for Xarelto in the United States.
While Aspirin continues to be widely used due its affordability and proven efficacy across various conditions; newer drugs like Xarelto are gaining popularity for specific uses such as prevention of strokes due their superior safety profiles regarding bleeding risks compared to older generation anticoagulants.
Conclusion
Both Aspirin (acetylsalicylic acid) and Xarelto (rivaroxaban) have proven efficacy in preventing blood clots, but they work through different mechanisms. Aspirin is an antiplatelet medication that prevents platelets from aggregating, thus stopping the formation of new clots. On the other hand, Xarelto is a type of anticoagulant known as a Factor Xa inhibitor and works by inhibiting one of the enzymes necessary for blood to clot.
Aspirin has been used for over 100 years and continues to be recommended by physicians worldwide due to its extensive track record and affordability. It's available over-the-counter making it more accessible; however, regular use may lead to gastrointestinal issues such as ulcers or bleeding.
Xarelto is newer on the market with fewer long-term studies available compared to aspirin but offers some advantages such as no need for blood monitoring which is required with some other anticoagulants. While it tends not to cause stomach upset like aspirin can do, it does carry significant risks including serious or fatal bleeding events.
It’s also worth noting that while both drugs are designed to prevent clotting, their different mechanisms mean they aren’t typically used interchangeably – your doctor will prescribe what suits your condition best.
The side effect profile is similar between these two medications - both are generally well-tolerated - yet each has unique risks tied closely with how they work: gastro-intestinal disturbances being common in aspirin users while hemorrhage being a concern in those taking Xarelto. Regular medical follow-up when taking either drug should be observed.