Dabigatran (Pradaxa®)

Dabigatran is an oral direct thrombin inhibitor and is indicated for stroke prophylaxis and systemic embolism prophylaxis in patients with non-valvular atrial fibrillation. Dabigatran is ONLY studied in patients 65 years and older with at least one other risk factor for stroke/embolism.

Important administration considerations:

1. 150mg twice daily
2. 75mg twice daily when CrCl is 15-30 mL/min (not based on any clinical data)
3. Can be taken with our without food
4. When converting patients from warfarin therapy to dabigatran, discontinue warfarin and start dabigatran when INR <2.0.
5. More expensive than warfarin
6. Needs to be kept in original bottle (cannot use pillbox)
7. No reversal agent
8. No INR monitoring required

Useful Links:

• Pradaxa website
• Relevant clinical trial RE-LY*

Current data:

• Editorial in Annals of Internal Medicine July 2012
• ISMP (Institute for Safe Medication Practices) Medication Safety Alert Quarter Watch 2011

*Some of the clinical trails require a subscription to view entire journal entry.