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Xarelto vs Savaysa
Introduction
For patients dealing with atrial fibrillation or deep vein thrombosis, there are certain anticoagulant drugs that can help in preventing blood clots and reducing the risk of stroke. Xarelto and Savaysa are two such medications often prescribed to manage these conditions. Both affect the body's clotting mechanism but their action is slightly different.
Xarelto is a direct factor Xa inhibitor, which means it works by directly inhibiting the activity of Factor Xa, an essential component in the formation of blood clots. On the other hand, Savaysa also belongs to this class of medication but has a unique aspect - its dosage may need adjustment based on kidney function levels.
Thus while both have effects in preventing harmful clotting events in patients at risk, consideration needs to be given regarding renal status when using Savaysa as opposed to Xarelto.
Xarelto vs Savaysa Side By Side
| Attribute | Xarelto | Savaysa |
|---|---|---|
| Brand Name | Xarelto | Savaysa |
| Contraindications | Should not be taken if you are taking, or have been taking medication to prevent blood clots like heparin within a 24-hour period. | Should not be taken if you are taking, or have been taking medication to prevent blood clots like heparin within a 24-hour period. |
| Cost | $470 to $540 for a month's supply | $400 to $450 for a month’s supply |
| Generic Name | Rivaroxaban | Edoxaban |
| Most Serious Side Effect | Unusual bleeding or bruising, signs of a severe allergic reaction, vision changes, heart problems, low red blood cells (anemia), spinal cord clot, symptoms indicating liver issues. | Signs of severe allergic reaction, unusual bleeding or bruising, blood in urine/stools, coughing up blood or vomit that looks like coffee grounds, dizziness or faintness, severe headaches and/or confusion, dark urine and jaundice-like symptoms. |
| Severe Drug Interactions | Adverse interactions with medications that prevent blood clots like heparin. | Adverse interactions with medications that prevent blood clots like heparin. |
| Typical Dose | 10-20 mg/day depending on the condition being treated | 60 mg/day, reduced to 30 mg/day for patients with moderate renal impairment or certain other conditions |
What is Xarelto?
Rivaroxaban (the generic name for Xarelto) and Edoxaban (the generic name for Savaysa) are both anticoagulants, marking a significant development from the earlier class of drugs known as vitamin K antagonists. Rivaroxaban was first approved by the FDA in 2011. Both medications work by inhibiting a specific protein in the blood called Factor Xa to prevent blood clots from forming, but they do so in slightly different ways. While both can be used to treat and prevent deep vein thrombosis (DVT), pulmonary embolism (PE), and atrial fibrillation, Rivaroxaban is also approved for reducing the risk of stroke in patients with nonvalvular atrial fibrillation. One advantage of Rivaroxaban over Edoxaban is that it requires no initial treatment with heparin, while Edoxaban does need initial co-treatment with parenteral anticoagulant therapy. However, compared to each other's influence on kidney function, Edoxaban has shown less renal impairment than Rivaroxban which makes it more tolerable among patients who have compromised kidney function.
What conditions is Xarelto approved to treat?
Xarelto is prescribed for the prevention and treatment of several different types of blood clots:
- Deep vein thrombosis (DVT), which can lead to pulmonary embolism in knee or hip replacement surgery patients.
- Stroke in people who have atrial fibrillation, not caused by a heart valve problem.
- Recurrent DVT and pulmonary embolism after initial treatment.
Savaysa, on the other hand, is approved for similar uses:
- To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
- For the treatment of deep vein thrombosis (DVT) following 5–10 days of initial therapy with a parenteral anticoagulant.
How does Xarelto help with these illnesses?
Xarelto, or rivaroxaban, is an oral anticoagulant that manages the risk of blood clots by blocking a key clotting protein called Factor Xa. By inhibiting the action of Factor Xa, it prevents thrombin generation and development of blood clots. This mechanism plays a crucial role in preventing heart attacks, strokes, and other conditions caused by blood clots. Blood has several components including platelets and plasma proteins which contribute to clotting; an imbalance in these can cause excessive clot formation leading to complications.
On the other hand, Savaysa (edoxaban) also works as an oral anticoagulant but operates slightly differently than Xarelto while still targeting Factor Xa. It's been designed for once-daily use with higher renal clearance making it potentially more suitable for patients with certain types of kidney disease. Both medications are effective at reducing stroke risk in individuals with nonvalvular atrial fibrillation but individual patient characteristics might make one drug preferable over another.
What is Savaysa?
Savaysa, also known by its generic name edoxaban, is an oral anticoagulant that acts as a direct factor Xa inhibitor. Similar to rivaroxaban (Xarelto), it works by preventing the formation of blood clots in the body. Savaysa was initially approved for medical use by the FDA in 2015.
Unlike rivaroxaban, which does not require routine blood monitoring or frequent dose adjustments, Savaysa may be more suitable for patients with kidney impairment since it offers a reduced dosage depending on renal function. Moreover, Savaysa has been found to cause fewer major bleeding incidents compared to warfarin - another commonly prescribed anticoagulant. Its mechanism of action means that its side-effect profile is different from other classes of anti-clotting drugs; however common side effects can include light-headedness and easy bruising or bleeding.
What conditions is Savaysa approved to treat?
Savaysa is an anticoagulant that has been approved by the FDA for several critical uses, including:
- Reduction in the risk of stroke and systemic embolism (blood clots) in patients with nonvalvular atrial fibrillation
- Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as prevention of recurrent DVT and PE following initial therapy.
How does Savaysa help with these illnesses?
Savaysa, like Xarelto, is an anticoagulant medication that works by inhibiting factor Xa in the blood clotting process. Factor Xa plays a key role in the coagulation cascade, which leads to blood clot formation. By blocking its action, Savaysa effectively thins the blood and reduces the risk of stroke or other serious cardiovascular events associated with atrial fibrillation (irregular heart rhythm) not caused by a heart valve problem. While both drugs are effective for this indication, Savaysa has a lower bleeding risk compared to traditional anticoagulants such as warfarin and some studies suggest it may also have a slightly lower bleeding risk than other novel oral anticoagulants including Xarelto. Moreover, Savaysa does not require regular monitoring of kidney function unlike Xarelto which might be beneficial in patients with fluctuating or poor renal functions.
How effective are both Xarelto and Savaysa?
Both rivaroxaban (Xarelto) and edoxaban (Savaysa) are anticoagulants that have been proven to prevent blood clots in patients with atrial fibrillation or undergoing hip or knee replacement surgery. Both medications were approved by the FDA within a few years of each other, Xarelto in 2011 and Savaysa in 2015. Since they act on different factors in the coagulation cascade, they may be prescribed under different circumstances.
The effectiveness of Xarelto and Savaysa was directly studied in several clinical trials; both drugs exhibited similar efficacy at preventing stroke or systemic embolism as well as comparable safety profiles. In these studies, none of the different metrics used to measure efficacy at preventing thromboembolic events differed significantly between patients receiving Xarelto and those receiving Savaysa.
A review published in 2016 indicated that Xarelto is effective at reducing stroke risk starting from the first week of treatment, has a favorable side effect profile compared to warfarin, another common anticoagulant, and is well-tolerated even among elderly populations. Further research shows that it remains one of the most widely-prescribed Factor-Xa inhibitors due its established history of effectiveness for treating deep vein thrombosis (DVT), pulmonary embolism (PE), nonvalvular atrial fibrillation (NVAF), etc.
In contrast, a meta-analysis conducted also showed that Savaysa appears more effective than placebo at preventing recurrent DVT/PE following initial therapy and seems similar to other common anticoagulants when it comes to NVAF management. Still, like all direct oral anticoagulants (DOACs), both drugs should be considered carefully against patient's existing renal function before prescription.
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At what dose is Xarelto typically prescribed?
Oral dosages of Xarelto range from 10-20 mg/day, depending on the specific condition being treated and the patient's renal function. For most adults in preventing stroke and systemic embolism, a common dose is 20 mg/day. Kidney function should be checked before starting treatment as it impacts dosing decisions. On the other hand, Savaysa dosage typically ranges between 15–60 mg/day based on the patient’s kidney function with usual doses for most patients being 60mg once daily. It is important that if there are signs of poor drug response or adverse reactions, healthcare professionals should be notified immediately to reassess dosage needs. The maximum recommended daily dosage of Savaysa is generally not more than 60mg per day.
At what dose is Savaysa typically prescribed?
Savaysa treatment typically begins with a dosage of 60 mg/day. Dosage can then be reduced to 30 mg/day for patients with moderate renal impairment, body weight less than or equal to 60 kg, or who are receiving concomitant P-gp inhibitors. The dose is taken once daily and should not exceed the prescribed amount per day. If there's no improvement in preventing stroke and systemic embolism after several weeks at this dosage, your doctor may reassess your condition and medication regimen. Always take Savaysa exactly as directed by your healthcare professional.
What are the most common side effects for Xarelto?
Some of the most common side effects reported with Xarelto include:
- Bleeding, including nosebleeds and heavier than normal menstrual bleeding
- Headache or dizziness
- Fatigue
- Muscle or joint pain
- Nausea, stomach upset, or diarrhea
- Itching
Meanwhile, Savaysa may also cause similar side effects such as:
- Unusual bleeding (nose, mouth, vagina, rectum), purple or red pinpoint spots under your skin
- Sudden severe headache or feeling like you might pass out.
- Heavy menstrual periods,
- Weakness on one side of your body,
- Slurred speech,
Always seek medical attention if any of these symptoms persist.
Are there any potential serious side effects for Xarelto?
While Xarelto and Savaysa are both anticoagulant medications, there are some potential side effects to be aware of. These include:
- Unusual bleeding or bruising, including frequent nosebleeds, unusual bleeding from gums, menstrual flow that is heavier than normal
- Signs of a severe allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Vision changes such as blurred vision or loss of vision
- Heart problems - chest pain or pressure, pain spreading to your jaw or shoulder
- Low red blood cells (anemia) - pale skin, light-headedness/dizziness especially upon standing up quickly after sitting/lying down for a long time.
- Spinal cord clot: back pain; numbness in lower body part; muscle weakness in the legs.
- Symptoms which may indicate liver issues: yellowing eyes/skin (jaundice), dark urine.
Any one experiencing these symptoms should immediately contact their healthcare provider.
What are the most common side effects for Savaysa?
While both Xarelto and Savaysa are anticoagulants used to prevent blood clots, the side effects can differ. With Savaysa, you may experience:
- Mild skin rash or itching
- Nausea, stomach pain
- Reduced kidney function
- Headache, dizziness
- Minor bleeding such as nosebleeds or bleeding gums Remember that while these side effects could be mild for some people, they could also be severe for others. Always consult your healthcare provider if you observe any of the above symptoms or other changes in your health condition while on medication.
Are there any potential serious side effects for Savaysa?
While Savaysa is generally well-tolerated by the majority of patients, it's important to be aware that in rare cases, serious side effects can occur. If you experience any of the following symptoms while taking Savaysa, seek immediate medical attention:
- Signs of severe allergic reaction: rash or hives; itching; swelling of your face, lips or throat; difficulty breathing
- Unusual bleeding or bruising (nosebleeds, bleeding gums), blood in urine/stools
- Coughing up blood or vomit that looks like coffee grounds
- Dizziness or faintness due to low hemoglobin levels
- Severe headaches and/or confusion which could indicate intracranial bleed
- Dark urine and jaundice-like symptoms suggesting liver issues
Remember these are not common occurrences but being observant about such changes can help avoid complications.
Contraindications for Xarelto and Savaysa?
Both Xarelto and Savaysa, along with most other anticoagulant medications, may increase the risk of bleeding. If you notice any unusual or prolonged bleeding such as frequent nosebleeds; heavy menstrual flows; blood in your urine or stools; coughing up blood; vomiting that resembles coffee grounds in color and texture; severe headaches or dizziness - please seek immediate medical attention.
Neither Xarelto nor Savaysa should be taken if you are taking, or have been taking medication to prevent blood clots like heparin within a 24-hour period. Always inform your healthcare provider about all the medicine you're currently on including over-the-counter drugs, vitamins, supplements and even herbal products. Certain medications might interact adversely with Xarelto and Savaysa leading to serious complications.
How much do Xarelto and Savaysa cost?
For the brand name versions of these drugs:
- Xarelto (rivaroxaban) is available in 10, 15 and 20 mg tablets. The price for a month's supply (30 tablets) averages around $470 to $540 which works out approximately $16 - $18/day depending on the dose.
- Savaysa (edoxaban), with strengths of 15, 30 and 60 mg, costs between about $400 and $450 for a month’s supply. This equates to roughly between $13 - $15 per day.
Thus, if you are taking higher doses of Xarelto (i.e., above the base dosage of Xarelto which is usually at least once daily), then Savaysa would be less expensive on a per-day treatment basis. Please note that cost should not be your sole consideration when choosing anticoagulant medication; it's important to weigh efficacy, side effects, interactions with other medications or medical conditions along with cost when making this decision.
As yet there are no generic versions of either Xarelto or Savaysa available in the U.S., but patient assistance programs may help defray costs for some patients who meet certain criteria.
Popularity of Xarelto and Savaysa
Rivaroxaban, which goes by the brand name Xarelto, is a type of anticoagulant medication that was prescribed to approximately 4 million people in the United States in 2020. Accounting for nearly 17% of all anticoagulant prescriptions, it is primarily used to prevent blood clots and strokes in individuals with certain types of heart disease or following joint replacement surgery.
On the other hand, edoxaban known by its brand name Savaysa, another anticoagulant medication prescribed to just under half a million people in the US during the same period. Edoxaban accounts for roughly 2% of all anticoagulant prescriptions. Primarily used for atrial fibrillation and deep vein thrombosis prevention after hip or knee replacement surgeries, Savaysa has seen a steady increase since its approval by FDA in late January 2015.
Conclusion
Both Xarelto (rivaroxaban) and Savaysa (edoxaban) are anticoagulants used for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, as well as for the treatment and prevention of deep vein thrombosis and pulmonary embolism. They work by inhibiting Factor Xa, an enzyme involved in blood clotting.
Xarelto is a once-daily medication that does not require regular blood monitoring or dietary restrictions, offering convenience to patients. On the other hand, Savaysa dosage is dependent on renal function: it's given at 60 mg daily for those with normal kidney function but reduced to half if certain levels of impairment are present.
Both drugs have similar side effect profiles which include bleeding risks; they should be discontinued prior to surgical procedures due to these risks. In case of major bleeding events, Andexxa can reverse the effects of both medications.
The decision between using Xarelto or Savaysa often depends on patient-specific factors such as renal function, risk profile for bleedings, cost considerations since neither drug has generic versions available yet, among others factors. Always consult your healthcare provider when deciding between different therapeutic options.
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Refrences
- Fukasawa, T., Seki, T., Nakashima, M., & Kawakami, K. (2022, September). Comparative effectiveness and safety of edoxaban, rivaroxaban, and apixaban in patients with venous thromboembolism: A cohort study. Journal of Thrombosis and Haemostasis. Elsevier BV.http://doi.org/10.1111/jth.15799
- Sarich, T. C., Peters, G., Berkowitz, S. D., Misselwitz, F., Nessel, C. C., Burton, P., … DiBattiste, P. M. (2013, May 23). Rivaroxaban: a novel oral anticoagulant for the prevention and treatment of several thrombosis‐mediated conditions. Annals of the New York Academy of Sciences. Wiley.http://doi.org/10.1111/nyas.12136
- Plosker, G. L. (2014, February 18). Rivaroxaban: A Review of Its Use in Acute Coronary Syndromes. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-014-0188-6