When You Can't Get Eliquis, What Are Your Options?

If you've been prescribed Eliquis (Apixaban) and can't get it filled — whether because your pharmacy is out of stock, insurance won't cover it, or the cost is too high — you're in a tough spot. Eliquis is a critical medication for preventing strokes and blood clots, and missing doses can be dangerous.

But Eliquis isn't the only blood thinner available. There are several alternatives your doctor may consider. This guide walks you through what Eliquis is, how it works, and the real alternatives that exist — so you can have an informed conversation with your healthcare provider.

Important: Never switch or stop blood thinners on your own. Any change must be made with your doctor's guidance.

What Is Eliquis?

Eliquis is the brand name for Apixaban, a prescription blood thinner manufactured by Bristol-Myers Squibb and Pfizer. It's classified as a direct oral anticoagulant (DOAC) and is one of the most widely prescribed medications in the United States.

Doctors prescribe Eliquis for:

• Reducing stroke risk in patients with nonvalvular atrial fibrillation (AFib)
• Treating deep vein thrombosis (DVT) and pulmonary embolism (PE)
• Preventing recurrent DVT and PE
• Preventing blood clots after hip or knee replacement surgery

For a deeper dive, check out What Is Eliquis? Uses, Dosage, and What You Need to Know.

How Does Eliquis Work?

Eliquis works by selectively blocking Factor Xa, a key protein in your body's blood-clotting process. Factor Xa converts prothrombin into thrombin, which is needed to form blood clots. By inhibiting this step, Eliquis reduces your body's ability to form harmful clots — without completely eliminating clotting, so you can still heal from cuts and injuries.

This mechanism is shared by some other DOACs, which is why alternatives in the same drug class can often be substituted. For a detailed explanation, see How Does Eliquis Work? Mechanism of Action Explained.

Alternatives to Eliquis

If you and your doctor decide to explore alternatives, here are the main options:

1. Xarelto (Rivaroxaban)

Xarelto is another Factor Xa inhibitor DOAC, similar in mechanism to Eliquis. Key differences:

• Dosing: Taken once daily (compared to Eliquis's twice daily), which some patients prefer for convenience
• Indications: Approved for AFib, DVT, PE, and also for reducing cardiovascular risk in patients with coronary artery disease (CAD) or peripheral artery disease (PAD)
• Food requirement: The 15 mg and 20 mg doses should be taken with food for proper absorption
• Cost: Similar to Eliquis at retail price, typically $500-$600 per month without insurance
• Reversal agent: Andexxa (andexanet alfa), the same reversal agent used for Eliquis

Xarelto is the most common alternative doctors consider when switching from Eliquis.

2. Pradaxa (Dabigatran)

Pradaxa works differently from Eliquis — instead of blocking Factor Xa, it directly inhibits thrombin (Factor IIa). Key points:

• Dosing: Taken twice daily, like Eliquis
• Indications: Approved for AFib, DVT, PE, and uniquely approved for pediatric patients age 8 and older
• Reversal agent: Praxbind (idarucizumab), a specific antidote that works within minutes — considered an advantage in emergency situations
• Storage: Must be kept in original packaging and used within 4 months of opening the bottle due to moisture sensitivity
• GI side effects: More likely to cause heartburn and stomach discomfort than Eliquis

3. Savaysa (Edoxaban)

Savaysa is another Factor Xa inhibitor with some unique characteristics:

• Dosing: Taken once daily
• Important limitation: Should not be used in AFib patients with creatinine clearance (CrCl) greater than 95 mL/min, as it was less effective in that population in clinical trials
• Requires initial parenteral therapy: For DVT/PE treatment, patients must start with 5-10 days of injectable anticoagulant (like heparin) before switching to Savaysa
• Cost: May be slightly less expensive than Eliquis or Xarelto, depending on insurance

4. Warfarin (Coumadin / Jantoven)

Warfarin is the oldest and cheapest option — it's been available as a generic for decades:

• Cost: As low as $4-$10 per month, making it by far the most affordable blood thinner
• Dosing: Taken once daily, but the dose varies and must be adjusted based on blood tests
• Monitoring: Requires regular INR blood tests (typically every 2-4 weeks) to make sure your blood isn't too thin or too thick
• Diet restrictions: Foods high in vitamin K (leafy greens, broccoli) can affect how Warfarin works, requiring consistent dietary habits
• Drug interactions: Interacts with many medications — more than any of the DOACs

Warfarin is a reliable option, especially when cost is the primary concern, but it requires more hands-on management than Eliquis or other DOACs.

How to Choose the Right Alternative

The best alternative depends on your specific situation. Factors your doctor will consider include:

• Your diagnosis: Not all blood thinners are approved for all conditions
• Kidney function: Some DOACs are eliminated by the kidneys and require dose adjustments
• Other medications: Drug interactions vary between blood thinners
• Convenience: Once-daily vs. twice-daily dosing, need for blood monitoring
• Cost and insurance coverage: What your plan covers and what you can afford
• Bleeding risk: Each anticoagulant has a slightly different bleeding profile

Never switch blood thinners without your doctor's guidance. The transition between anticoagulants requires careful timing to avoid gaps in protection or dangerous overlap.

Final Thoughts

Not being able to fill your Eliquis prescription is stressful, but you have options. Several effective alternatives exist, each with their own pros and cons. The most important thing is to work with your doctor to find a safe substitute — and to never stop taking your blood thinner without medical advice.

If your issue is finding Eliquis in stock rather than needing a permanent switch, try using Medfinder to locate nearby pharmacies, or read our guide on how to find Eliquis in stock near you. If cost is the barrier, see How to Save Money on Eliquis in 2026.