Xarelto®
The commercial product Xarelto® contains the active ingredient rivaroxaban. It is a direct and reversible inhibitor of coagulation factor 10, which also plays a very important role in blood coagulation. The indications are similar to those for other blood-clotting inhibitors.
Rivaroxaban has a half-life of 7-11 hours. This makes it more flexibly controllable. Under the therapy of Xarelto®, the same conditions and limits apply with regard to coagulation monitoring as with Pradaxa®.
The active ingredient rivaroxaban is partially metabolized by the same enzymes as Marcumar®. This topic may also be of interest to you:
- Xarelto® and alcohol
Another portion is also metabolized via a P-glycoprotein. Interaction with other drugs is low, but may occur.
More rarely, interactions with certain ingredients in food occur. Xarelto® is excreted 1/3 via the kidneys. If uncontrolled bleeding or other side effects occur, it is problematic to react quickly to the active ingredient rivaroxaban.
The overdose countermeasures used with phenprocoumon do not work here. The same applies to dabigatran etexilate. However, Pradaxa® has a so-called antidote. For rivaroxaban this does not yet exist at present, but is to be developed. In terms of cost, Xarelto® is somewhat cheaper than Pradaxa®, but also considerably more expensive than Marcumar®.
Eliquis®
The commercial product Eliquis® contains the active ingredient Apixaban. It is also a direct and reversible inhibitor of blood coagulation factor 10 and belongs to the same substance class as Xarelto®. It therefore has similar properties to Xarelto®.
It is a little younger. While Xarelto® was launched in 2008, Eliquis® has been on the market since 2011. The indications are similar.
The so-called pharmacokinetics differ slightly. This means that how the organism acts on the drug differs between the preparations. Elquis® has a half-life of 9-14 hours.
It has a slightly lower bioavailability. According to this, it has a bioavailability of 50%, while Xarelto® has a bioavailability of over 80%. This can have advantages and disadvantages.
A higher bioavailability means a stronger distribution and effect in the body. It also means that the side effects, such as bleeding tendencies, can be more pronounced.An antidote is also currently being developed for the active substance Apixaban. Eliquis® is excreted 1/4 via the kidney and 3/4 via the gall bladder.
There are certain contraindications for Pradaxa®, Elquis® and Xarelto®. These include pregnancy, as well as acute, clinically relevant bleeding, conditions with risk factors for heavy bleeding and concomitant use of other anticoagulants such as heparin. The recommendation for kidney dysfunction differs for the three preparations.
