In the midst of thousands of lawsuits concerning uncontrollable bleeding problems associated with the blood thinners Xarelto and Pradraxa, a new anticoagulant is being pushed on the market that also lacks a reversal agent to stop hemorrhaging in users.

The new blood thinner Eliquis (apixaban) is being heavily marketed by manufacturers Pfizer and Bristol-Myers Squibb as being overtly superior to Pradaxa and Xarelto in stopping strokes in patients with atrial fibrilation, despite pre-clinical trials indicating the same level of success. Medical experts are concerned because Eliquis also lacks a key safety characteristic that Xarelto and Pradaxa lack, which is that none of the drugs have an approved antidote to stop bleeding should it occur.

This differs from the original blood thinner on the market, warfarin (coumadin), which works slower than the new generation anticoagulants but has an established stopping agent, vitamin K, if patients start hemorrhaging.

The pharmaceutical companies behind Xarelto, Pradaxa and Eliquis recently started a major marketing showdown to secure their share of the anticoagulant market, which focused on direct-to-consumer advertising.

Eliquis direct-to-consumer ads were highlighted in a recent study published in Medical Care, where several experts complained that the ads misrepresented the level of preference prescribing physicians had for the drug. This misrepresents a false favoritism, and most likely caused a lot of unnecessary prescriptions to be prescribed, experts hypothesized.

It is important to note that out of the new generation of blood thinners, doctors know the least about Eliquis. Sine it is so new, Eliquis has the least amount of bleeding injury reports, which means physicians are not fully aware of the nature of Eliquis bleeding injuries. A recent study published in the Journal of Neurosurgery stated that Eliquis lacked an extreme amount of experimental and clinical data available to the medical community.

Overview of Direct Thrombin Inhibitor Complications

Ever since they were first introduced to the market, direct thrombin inhibitors have been aggressively advertised as superior to their predecessor, warfarin. Unlike warfarin, these drugs do not require frequent blood monitoring or dose adjustments. Additionally, these drugs also lack a bleeding reversal agent, which means patients require hospital intervention in these scenarios.

When Pradaxa was introduced to the United States in 2010, it was the first drug to compete with warfarin. Pradaxa is manufactured by Boehringer Ingelheim. Soon after its release, it became a marketing success but also was the subject of criticism by medical and legal experts. The risk of uncontrollable internal bleeding was not mentioned on Pradaxa’s warning labels, leading to the German pharmaceutical giant facing thousands of Pradaxa product liability lawsuits. In 2014, Boehringer agreed to pay $650 million to settle approximately 4,000 Pradaxa lawsuits, which averages to about $150,000 per case.

In a similar scenario, Xarelto was introduced in 2011 to be competitor of Pradaxa and warfarin. It was released as a joint venture by Bayer Pharmaceuticals and Janssen Pharmaceuticals, which launched an advertising campaign that rivaled that of Eliquis’ marketing campaign. Xarelto also become a marketing success, even beating Pradaxa in popularity, but also came with a lack of warning about internal bleeding on the drug’s label. So far dozens of Xarelto lawsuits have been filed by injured patients.

While it remains to be seen as to whether or not Eliquis will become a similar story to Xarelto and Pradaxa, experts speculate that it will soon become apparent. Similar to Pradaxa and Xarelto, Eliquis is expected to become a financial success, but it also lacks an established reversal agent. Already numerous Eliquis bleeding lawsuits have been filed by patients injured by uncontrollable hemorrhaging on the drug.