Dosage Forms. Capsule: 75 mg, 150 mg
Common FDA Label Indication, Dosing, and Titration.
1. Prevention of thromboembolism in patients with atrial fibrillation: 150 mg po bid
1. Prevention of thromboembolism after orthopedic surgery: 150 mg po bid
2. Prevention of thromboembolism recurrence: 150 mg po bid
MOA. Dabigatran is a competitive, direct thrombin inhibitor. Because thrombin enables the conversion of fibrinogen into fibrin during the coagulation cascade, its inhibition prevents the development of a thrombus. Both free and clot-bound thrombin and thrombin-induced platelet aggregation are inhibited.
Drug Characteristics: Dabigatran
Medication Safety Issues: Dabigatran
Drug Interactions: Dabigatran
Adverse Reactions: Dabigatran
Efficacy Monitoring Parameters. Prevention of clotting or recurrence of clotting. The aPTT assay can be used as a qualitative indicator of anticoagulation status.
Toxicity Monitoring Parameters. Monitor for signs and symptoms of bleeding; evaluate renal function.
Key Patient Counseling Points. May be given with or without food. Do not open capsules. Treatment must be suspended prior to surgical procedures, using protocols provided in the product package insert. Increased risk of stroke on discontinuation.
Clinical Pearls. Detailed dosing conversion protocols are used to convert patients from warfarin or parenteral anticoagulants to dabigatran are available in the product package insert. Dispense in manufacturer original bottle and discard remaining doses 4 mo after opening. Guidelines recommend against use in advanced liver disease or CrCl <15 mL/min. Medication guide required at dispensing.