What are the differences between Xarelto and Pradaxa?
Choosing a prescription that’s right for you can be a tedious process. So many things must be taken into consideration. What are the possible side effects? How does it compare with the other drugs of its class? Hopefully this article can give you a little insight into the pros and cons of the blood thinners Xarelto and Pradaxa.
Xarelto is manufactured and marketed by Bayer and Janssen Pharmaceuticals. It’s primarily used as a preventative measure against blood clotting and strokes in patients suffering from nonvavular atrial fibrillation, deep vein thrombosis, pulmonary embolism, as well as those that have had hip and knee replacement surgery. Unlike its predecessor Camoudin the use of Xarelto does not require any dietary restrictions or monthly blood tests, which makes it convenient to use. It works by inhibiting the activity of the clotting factor factor Xa, which prevents the synthesis of thrombin. Once consumed Xarelto is rapidly absorbed and reaches 2-4 hrs after being administered. Some of the medication is removed unchanged by the kidneys. Xarelto, however, lacks an antidote to counteract its action and cannot be removed by dialysis. This has resulted in lawsuits being filed against Bayer and Janssen Phamarceuticals because users of Xarelto were either hospitalized or died from excessive bleeding while on the medication. Fortunately for Xarelto, it has a short half-life of 4-9 hrs of activity compared to camoudin’s 40 hrs, so some bleeding events can be managed by discontinuing the use of the medication. Unlike Camoudin, Xarelto comes in standardized doses that must be taken with food to increase absorption. Xarelto can be split, chewed, or crushed before being consumed.
Pradaxa is the predecessor of Xarelto. It’s manufactured by Bayer’s competitor Boehringer-Ingelheim. Pradaxa much like Xarelto is primarily used as a preventative measure against blood clotting and strokes in patients suffering from nonvavular atrial fibrillation, deep vein thrombosis, pulmonary embolism, as well as those that have had hip and knee replacement surgery. But when Xarelto was introduced to the market in 2011 Pradaxa’s sales began to take a nosedive. Much like Xarelto, Pradaxa has no dietary restrictions or requirement for monthly blood tests, which makes it convenient to use. Instead of inhibiting factor Xa like Xarelto does, Pradaxa works by inhibiting the thrombin-dependent conversion of fibrinogen to fibrin. When consumed the drug is rapidly absorbed and reaches peak 1-2 hrs after being administered. After being administered most (80%) of it is removed by the kidney. Much like its successor Pradaxa lacks an antidote to counteract its activity in the case of an overdose or bleeding event. As a consequence of this, Boehringer-Ingelheim has received several lawsuits from individuals that have been hospitalized or from relatives whose loved ones have died as a result of uncontrolled bleeding caused by Pradaxa. Boehringer-Ingelheim later settled these lawsuits for a whopping $650 million. On the bright side, there is evidence out there that hemodialysis can remove Pradaxa. Clinical data, however, is limited. Unlike its successor, Pradaxa must be taken twice daily but can be taken with or without food. On the other hand, it cannot be crushed, split, or chewed before being consumed. A side by side comparison of Pradaxa’s and Xarelto’s efficacy cannot be made because no head to head studies have been done to compare this characteristic.