Dabigatran

Dabigatran Brand Name– Pradaxa

What is Dabigatran

Dabigatran is an oral direct thrombin inhibitor indicated for reduction of risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation, for treatment and reduction in the risk of recurrence of deep venous thrombosis (DVT) and pulmonary embolism (PE), and for the prophylaxis of DVT and PE following hip replacement surgery.

It is also approved in Canada and Europe for thromboprophylaxis in patients undergoing knee replacement surgery.

Routine monitoring of dabigatran is not required.

A reversal agent, idarucizumab, is available when the reversal of the anticoagulant effect of dabigatran is needed for emergency surgery, urgent procedures, or in cases of life-threatening or uncontrolled bleeding.

Dabigatran was FDA-approved in October 2010.

Indications

1. atrial fibrillation
2. deep venous thrombosis (DVT)
3. deep venous thrombosis (DVT) prophylaxis
4. pulmonary embolism
5. pulmonary embolism prophylaxis
6. stroke prophylaxis

Side Effects

1. abdominal pain
2. alopecia
3. anaphylactic shock
4. anaphylactoid reactions
5. angioedema
6. bleeding
7. dyspepsia
8. edema
9. esophageal ulceration
10. esophagitis
11. gastritis
12. gastroesophageal reflux
13. GI bleeding
14. intracranial bleeding
15. myocardial infarction
16. peptic ulcer
17. pericardial effusion
18. pruritus
19. rash
20. spinal hematoma
21. stroke
22. thrombocytopenia
23. thrombosis
24. urticaria

Monitoring Parameters

• serum creatinine

Contraindications

• abrupt discontinuation
• anticoagulant therapy
• antiphospholipid antibody syndrome
• bleeding
• breast-feeding
• children
• dialysis
• epidural anesthesia
• geriatric
• infants
• intramuscular injections
• labor
• lumbar puncture
• mechanical heart valves
• neonates
• obstetric delivery
• pregnancy
• prosthetic heart valves
• renal failure
• renal impairment
• spinal anesthesia
• surgery

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