Heart Health

The best anti-clotting drug for afib?

Ask the doctor

By , Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing

illustration showing plaque buildup in a blood vessel and a clot forming in the narrowed portion

Q. I have atrial fibrillation and take Xarelto. But I heard about a study that suggests Eliquis is more effective for preventing strokes in people with atrial fibrillation. I'm wondering if I should switch. Your thoughts?

A. Both of these anti-clotting medications, rivaroxaban (Xarelto) and apixaban (Eliquis), are FDA-approved for preventing strokes in people with atrial fibrillation (afib). They both belong to a class of drugs known as direct oral anticoagulants, or DOACs. They work by inhibiting a substance called factor Xa, which plays a key role in blood clot formation. And both drugs have a half-life of about eight hours, which means that the blood level of the drug drops by half over an eight-hour period. But there are some differences between the two.

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About the Author

photo of Christopher P. Cannon, MD

Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Christopher P. Cannon is editor in chief of the Harvard Heart Letter. He is a professor of medicine at Harvard Medical School, and senior physician in the Preventive Cardiology section of the Cardiovascular Division at … See Full Bio
View all posts by Christopher P. Cannon, MD

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Managing Atrial Fibrillation will explain what atrial fibrillation is, how to know if you have it, its causes, and the treatments available. Afib can be a complex health condition, so the more you know about it, the better you will be able to work with your doctor. If afib is monitored and treated correctly, you can minimize its symptoms and help to prevent serious complications like stroke and heart damage.

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