Dabigatran

  • An oral direct thrombin inhibitor approved for :

             1) Stroke prevention in atrial fibrillation

             2) Treatment of DVT and PE in patients who have been treated with a parenteral anticoagulant for 5-10 days

             3) Long term prevention of recurrent DVT/PE in patients who have been previously treated for DVT/PE

 

Relevant Clinical Trials

Stroke Prevention in Atial Fibrillation

Treatment of DVT/PE

Extended Treatment of DVT/PE

Monitoring

  • Dabigatran is not intended to be monitored using routine coagulation testing.  Its fixed dosing is not intended to be adjusted on the basis of any coagulation laboratory parameter. 

    In certain clinical situations in which the presence or absence of anticoagulant effect induced by dabigatran needs to be measured, the UW Medicine Dabigatran Assay can be used.

Administration Considerations

  • Do not break, chew or crush capsules
  • Keep capsules in original container – do not store or place in other containers
  • After opening original container, capsules expire in 120 days

Suggestions for Reversal and Management of Bleeding

 

Mild Bleeding                                       

  • Delay next dose or discontinue therapy

Moderate to Severe Bleeding

  • Symptomatic treatment
  • Mechanical compression
  • Surgical intervention
  • Fluid replacement and hemodynamic support
  • Blood product transfusion
  • Oral charcoal (if dabigatran administered < 2 hrs prior)
  • Hemodialysis (60% removal)

Life Threatening Bleeding

  • Measures above
  • Charcoal filtration
  • Idarucizumab (Praxbind)