Dabigatran, Pradaxa
Description: Anticoagulant; Direct Thrombin Inhibitor.
“Alert: Black Box Warning
Thrombotic events:
Premature discontinuation of dabigatran increases the risk of thrombotic events. If anticoagulation with dabigatran is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant.
Spinal/Epidural hematoma:
Epidural or spinal hematomas may occur in patients treated with dabigatran who are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include use of indwelling epidural catheters; concomitant use of other drugs that affect hemostasis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors, or other anticoagulants; a history of traumatic or repeated epidural or spinal punctures; a history of spinal deformity or spinal surgery; optimal timing between the administration of dabigatran and neuraxial procedures is not known.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Dabigatran, Pradaxa is a competitive, direct thrombin inhibitor. Because thrombin (serine protease) enables the conversion of fibrinogen into fibrin during the coagulation cascade, it inhibits coagulation by preventing thrombin-mediated effects including the conversion of fibrinogen to fibrin, activation of factors V, VIII, XI, and XIII, and inhibition of thrombin-induced platelet aggregation.
Indications For Use
Deep venous thrombosis and pulmonary embolism, non-vascular atrial fibrillation, venous thromboembolism prophylaxis in total hip arthroplasty.
Precautions
Before starting Dabigatran, Pradaxa makes sure your physician is aware of any allergies or medications you currently take. There is a risk of bleeding and thromboembolic events upon discontinuation of therapy. Patients with antiphospholipid syndrome and/or heart valvular disease should not take Dabigatran, Pradaxa.
Usual Dosing
Oral: 110mg daily to 150mg twice daily depending upon indication.
Pharmacist Tips On Using
How to Take: Can be taken with or without food with a full glass of water. If you experience dyspepsia then consider adding it to meals. Do not break, chew, or open capsules, as this will lead to a 75% increase in absorption and potentially serious adverse reactions.
Side Effects
Gastrointestinal symptoms such as abdominal discomfort, dyspepsia, epigastric pain, gastroesophageal reflux disease, gastritis; hemorrhage.
Note this is not a complete list of side effects for Dabigatran, Pradaxa
Frequently Asked Questions
Why would my doctor give this to me if it can cause me to have a potentially fatal bleed, is it safe?
Your physician has found that given your medical conditions the reduction of risk of a major clot resulting in a heart attack or stroke far outweighs the increased risk of a bleed. Every medication does have risks however the training of your medical team has established that the benefits outweigh said risks based on their many years of experience, schooling, training, and available clinical data.