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BLOOD AND BLOOD FORMING ORGANS › ANTITHROMBOTIC AGENTS › ANTITHROMBOTIC AGENTS › Direct thrombin inhibitors
dabigatran etexilate
B01AE07
Forms & Strengths
- Oral capsules: 75 mg
- Oral capsules: 110 mg
- Oral capsules: 150 mg
Adult Dosing
- Non-valvular atrial fibrillation: 150 mg PO BID; reduce to 75 mg or 110 mg BID based on renal function and age
- Treatment/prevention of DVT/PE: 150 mg PO BID initiated after 5-10 days of parenteral anticoagulation
- Post-operative DVT/PE prophylaxis (knee/hip replacement): 110 mg on day 1, then 220 mg PO daily
Pediatric Dosing
- VTE treatment in pediatric patients (0 to <18 years): Weight- and age-based dosing regimens using capsules or pellets
- Pediatric dosing is weight-adjusted per institutional or approved labeling protocols
Indications
- Reduction of risk of stroke and systemic embolism in non-valvular atrial fibrillation
- Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE)
- Reduction in the risk of recurrence of DVT and PE
- Prophylaxis of DVT and PE following hip replacement surgery
Mechanism of Action
- Direct, reversible, competitive inhibitor of free and thrombin-bound factor IIa (thrombin)
- Prevents the cleavage of fibrinogen to fibrin, thereby inhibiting thrombus development
Contraindications
- Active pathological bleeding
- History of serious hypersensitivity reaction to dabigatran
- Mechanical prosthetic heart valves
Adverse Reactions
- Major bleeding events
- Minor bleeding (epistaxis, gastrointestinal hemorrhage)
- Dyspepsia and gastritis-like symptoms
- Abdominal pain
Drug Interactions
- P-glycoprotein inducers (e.g., rifampin): decrease dabigatran efficacy, avoid concomitant use
- P-glycoprotein inhibitors (e.g., ketoconazole, dronedarone): increase exposure, may require dose adjustment
- Anticoagulants, antiplatelets, NSAIDs: increase risk of serious bleeding complications
Curated Content: Needs Vetting Before Put to Clinical Use