What to Know About Xarelto Generics: U.S. vs. Canadian Options in 2025

What to Know About Xarelto Generics: U.S. vs. Canadian Options in 2025

Xarelto (rivaroxaban) is a widely prescribed blood thinner used to prevent strokes, deep vein thrombosis (DVT), pulmonary embolism, and blood clots in patients with atrial fibrillation or after certain surgeries. Until recently, all strengths of Xarelto in the United States were only available as brand-name—making it an expensive long-term therapy for many patients.

In 2024, a generic version of Xarelto 2.5 mg was finally approved in the U.S., but most other strengths, including 10 mg, 15 mg, and 20 mg, remain brand-name only. Meanwhile, Canada already has access to a broader range of generic rivaroxaban strengths—creating a gap in affordability and access between the two countries.

Here’s what patients need to know.

What Is the Status of Xarelto Generics in the U.S.?

As of 2025, the FDA has approved only the 2.5 mg strength of rivaroxaban for generic use in the U.S. This low-dose option is most commonly used in combination with aspirin for cardiovascular event prevention in patients with chronic coronary or peripheral artery disease.

Patients taking higher doses—such as 10 mg once daily for DVT prevention or 20 mg daily for atrial fibrillation—are still limited to the brand-name version of Xarelto, which can cost over $500 per month without insurance.

Why Only 2.5 mg?

Patent protections still remain for the higher-dose strengths of Xarelto. These patents delay full generic competition in the U.S., which would normally lower prices. Until those expire—projected around 2026–2027—patients needing higher doses may not see major price drops domestically.

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What About Canada?

In Canada, generic versions of rivaroxaban are already approved and available in multiple strengths—including 10 mg, 15 mg, and 20 mg. This broader availability offers significant savings for patients in the U.S. who are paying out of pocket.

For example:

  • Rivaroxaban 20 mg (generic in Canada): Available for around $115 for 100 tablets.
  • Brand-name Xarelto 20 mg in the U.S.: Often costs over $500/month without coverage

Because of Health Canada’s drug pricing regulations, the cost of both brand-name and generic drugs is generally lower than in the U.S., and U.S. patients can import a 90-day supply for personal use with a valid prescription.

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Can U.S. Patients Order Generic Rivaroxaban from Canada?

Yes. U.S. residents with a valid prescription from their doctor can use a prescription referral service to order their medication from licensed Canadian pharmacies. This is commonly done for long-term medications that are either:

  • Too expensive in the U.S.
  • Not yet available in generic form domestically

While only the 2.5 mg dose is generic in the U.S., Canadian options allow patients to access the full range of generic rivaroxaban strengths at lower costs.

Why This Matters for Patients

Xarelto is often taken daily for life, especially in conditions like non-valvular atrial fibrillation or after serious clotting events. High out-of-pocket costs can lead to non-adherence, which increases the risk of strokes, clots, and hospitalizations.

Until full generic access is available in the U.S., Canadian pharmacies continue to offer an important, cost-saving alternative.

What If the Medication Doesn’t Work as Well After Restarting?

After a long break, some people find that restarting the medication doesn’t bring the same appetite control or blood sugar stability. If this happens, a few things could be happening:

  • Your body may have developed a temporary tolerance
  • You might need a slower titration plan
  • Diet and activity levels during the break may affect results

Your healthcare provider can help adjust your plan or explore other GLP-1 options like Mounjaro or Zepbound if the current medication is no longer effective.

Final Thoughts

The introduction of a 2.5 mg generic for Xarelto in the U.S. is a step in the right direction—but it doesn’t help the majority of patients who require higher strengths for atrial fibrillation or clot prevention. Until the remaining patents expire, ordering generic rivaroxaban from Canada remains one of the most affordable and legal options for American patients looking to stay on therapy without breaking the bank.

For those paying out of pocket, it’s worth exploring whether a Canadian prescription referral service can provide safe access to generic Xarelto 10 mg, 15 mg, or 20 mg at a much lower cost.

FAQs

Is Xarelto available as a generic in the U.S.?
Yes, but only the 2.5 mg strength has FDA approval for generic use. Higher doses like 10 mg and 20 mg are still brand-only.

When will other Xarelto doses go generic in the U.S.?
Patent protections for the 10 mg, 15 mg, and 20 mg strengths are expected to expire between 2026 and 2030, depending on legal outcomes.

Can I legally buy generic Xarelto from Canada?
Yes. U.S. patients can import a 90-day supply of Health Canada–approved medications for personal use with a valid prescription.

Is Canadian generic rivaroxaban safe?
Yes. Medications sourced from licensed Canadian pharmacies are regulated by Health Canada and must meet strict quality and safety standards.

How much can I save by buying generic Xarelto from Canada?
Many patients save 50% or more. For example, 20 mg generic rivaroxaban is often under $120 for a 100-day supply through Canadian sources.