Dabigatran

Characteristics

• Dabigatran is a thrombin inhibitor
• It is a prodrug activated by esterase enzymes
• It is 80% excreted by the kidneys: the dose is halved in renal insufficiency
• It is non-inferior to Warfarin over 2 years
• A prolonged aPTT value indicates a therapeutic or supratherapeutic drug level

Complications

Interactions

Treatment of bleeding: Idarucizumab

Treatment of bleeding: other measures

References

1. Hart RG, Diener HC, Yang S, et al. Intracranial hemorrhage in atrial fibrillation patients during anticoagulation with warfarin or dabigatran: the RE-LY trial. Stroke 2012; 43:1511-1517.
2. Connolly SJ, Ezekowitz MD, Yusuf S, et al; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361:1139-1151. 
3. Thibault N, Morrill AM, Willett KC. Idarucizumab for reversing dabigatran-induced anticoagulation: a systematic review. Am J Ther 2016; 25:e333-e338.
4. Kim J, Jang HJ, Schellingerhout D, et al. Short-term cessation of dabigatran causes a paradoxical prothrombotic state. Ann Neurol 2021; 89:444-458.
5. Burness CB. Idarucizumab: First global approval. Drugs 2015; 75:2155-2161.
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Related checklists

• Rivaroxaban
• Apixaban
• Edoxaban
• New oral anticoagulants (NOACs): management of bleeding