Dabigatran

Anticoagulant Drug

Drug class: Direct Thrombin Inhibitor

Dabigatran (PRADAXA)（中文：達比加群）

Common Strengths of Dabigatran

Dabigatran are available in the following strengths:

• 75 mg, 110 mg, and 150 mg capsules

Drug Trade Names of Dabigatran

Pradaxa

Drug Usage

• Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
• Treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE)
• Prevention of blood clots after hip or knee replacement surgery

Mechanism of Action

Directly inhibits thrombin, preventing blood clot formation

Route of Administration

Oral

Dosages

• For atrial fibrillation: 150 mg twice daily

Renal dose based on eGFR:

• eGFR >50 mL/min: No dosage adjustment required, standard dose of 150 mg twice daily
• eGFR 30-50 mL/min:
  • 75 mg twice daily for stroke prevention in atrial fibrillation
  • 150 mg twice daily for treatment of DVT/PE, but use with caution
• eGFR 15-30 mL/min: 75 mg twice daily for stroke prevention in atrial fibrillation

Side Effects

Frequency	Adverse reactions
Common	Indigestion
	Heartburn
	Abdominal pain
	Diarrhea
	Minor bleeding
Uncommon	Nausea, vomiting
	Severe heartburn
	Bleeding
	Intracranial hemorrhage

Pharmacokinetics

• Absorption
  • Peak plasma time 1 - 2 hours
• Metabolism
  • Converted to active form dabigatran
• Elimination
  • Primarily renal (80%)
• Half-life
  • 12 to 17 hours
• Drug duration
  • 12 to 17 hours

Drug Precautions

Pregnancy

Not recommended

Breastfeeding

Not recommended

Children and Elderly

• Children: Safety and efficacy not established
• Elderly: Increased risk of bleeding

Monitoring Requirements

Renal function, signs of bleeding

Drug interactions

P-gp inhibitors, anticoagulants, NSAIDs, antiplatelet drugs

Caution

• Use with caution in the elderly and in patients with low body weight
• Use with caution in patients with bleeding disorders, gastritis, and oesophageal reflux

FAQ

How Should I Take the Tablet?

Swallow capsules whole with water, with or without food. Do not open, break, or chew the capsules

What Should I Avoid While Taking?

Activities that increase the risk of bleeding or injury

What Happens if I Miss a Dose?

Take as soon as remembered if more than 6 hours until the next dose. If less than 6 hours, skip the missed dose and take the next scheduled dose.