Dabigatran Etexilate Mesylate(da bye gah’ tron)
PradaxaDNC
PREGNANCY CATEGORY C
Drug Classes
Direct thrombin inhibitor
Therapeutic Actions
Competitive, direct thrombin inhibitor; thrombin enables the conversion of fibrinogen to fibrin fibers during the clotting cascade. Inhibiting this process prevents clot development. Dabigatran inhibits free and clot-bound thrombin and thrombin-induced platelet aggregation.
Indications
Reduction of the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
Available Forms
CapsulesDNC—75, 150 mg
Dosages
Adults
150 mg PO bid. If converting from warfarin to dabigatran, stop warfarin and begin dabigatran when INR is less than 2. If converting to warfarin based on CrCl levels: For CrCl of more than 50 mL/min, start warfarin 3 days before ending dabigatran; for CrCl of 30–50 mL/min, start warfarin 2 days before stopping dabigatran; for CrCl of 15–30 mL/min, start warfarin 1 day before stopping dabigatran. If converting from a parenteral anticoagulant, start dabigatran 0–2 hr before next dose of parenteral drug would have been given, or at time of discontinuation of continuous infusion of parenteral anticoagulant. If patient is taking dabigatran and needs to be started on a parenteral anticoagulant, wait 12 hr (if CrCl is 30 mL/min or more) or 24 hr (if CrCl is less than 30 mL/min) after last dose of dabigatran before beginning parenteral drug.
Pediatric patients
Safety and efficacy not established.
Patients with renal impairment
If CrCl is 15–30 mL/min, give 75 mg PO bid.
Pharmacokinetics
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