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Dabigatran

Brand: Pradaxa

Direct thrombin inhibitor (DOAC)Used for: Prevent and treat blood clotsCardiovascular
Boxed warning · ISMP high-alert drug

Stopping early raises the risk of thrombotic events and stroke; spinal or epidural hematoma with neuraxial anesthesia or spinal puncture.

Caution
Bleeding risk rises with age and kidney impairment; contraindicated with mechanical heart valves.
Storage
Keep capsules in the original bottle or blister (they absorb moisture) and use within 4 months of opening the bottle.

Common side effects

  • Bleeding and bruising
  • Indigestion and stomach upset
  • Nausea

Key interactions

  • Additive bleeding risk with NSAIDs and antiplatelets
  • Rifampin and St. John's wort lower its level
  • Reversed specifically by idarucizumab

Counseling points

  • Keep capsules in the original bottle: they absorb moisture
  • Use within 4 months of opening the bottle
  • Do not open, crush, or chew the capsule
  • No routine INR monitoring is needed
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