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