Cardiologists prescribing rivaroxaban more than warfarin

Cardiologists are increasingly bypassing the anticoagulant warfarin in favor of rivaroxaban, a more-expensive alternative with fewer side effects, according to the IMS NPA Weekly.

Janssen, the maker of rivaroxaban (Xarelto), recently reported that the drug captured 40% of the prescription market as of May 10, 2013, compared to the 35% share for warfarin. The FDA has approved rivaroxaban for the prevention of stroke in nonvalvular atrial fibrillation, several indications for deep vein thrombosis, and hip and knee surgery.

Rivaroxaban does not have to be monitored as frequently as warfarin, has few drug-drug interactions, and has practically no drug-food interactions.  However, rivaroxaban is more costly, about $8 per pill, compared to warfarin, according to IMS NPA Weekly.

Also, with rivaroxaban there is no antidote to reverse its drug thinning effect, whereas warfarin does have specific reversal agents for bleeding.