Book contents
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
37 - Dabigatran Etexilate
Published online by Cambridge University Press: 06 October 2020
- Frontmatter
- Contents
- List of icons
- Preface
- Acknowledgements
- 1 Acetazolamide
- 2 Alemtuzumab
- 3 Almotriptan
- 4 Alteplase
- 5 Amantadine
- 6 Amifampridine
- 7 Amitriptyline
- 8 Apixaban
- 9 Apomorphine
- 10 Aprepitant
- 11 Aripiprazole
- 12 Armodafinil
- 13 Aspirin (Acetylsalicylic Acid)
- 14 Azathioprine
- 15 Baclofen
- 16 Benztropine
- 17 Bevacizumab
- 18 Botulinum Toxin Type A
- 19 Botulinum Toxin Type B
- 20 Bromocriptine
- 21 Bupropion
- 22 Carbamazepine
- 23 Carisoprodol
- 24 Carmustine
- 25 Chlorpromazine
- 26 Citalopram
- 27 Clobazam
- 28 Clonazepam
- 29 Clonidine
- 30 Clopidogrel
- 31 Clozapine
- 32 Corticotropin
- 33 Cyclobenzaprine
- 34 Cyclophosphamide
- 35 Cyclosporine (Ciclosporin)
- 36 Cyproheptadine
- 37 Dabigatran Etexilate
- 38 Dalfampridine
- 39 Dantrolene
- 40 Desvenlafaxine
- 41 Dexamethasone
- 42 Dextromethorphan/Quinidine
- 43 Diazepam
- 44 Diclofenac
- 45 Dihydroergotamine
- 46 Dimethyl Fumarate
- 47 Dipyridamole and Aspirin
- 48 Donepezil
- 49 Droperidol
- 50 Droxidopa
- 51 Duloxetine
- 52 Edoxaban
- 53 Edrophonium
- 54 Eletriptan
- 55 Entacapone
- 56 Escitalopram
- 57 Eslicarbazepine Acetate
- 58 Ethosuximide
- 59 Everolimus
- 60 Ezogabine
- 61 Felbamate
- 62 Fingolimod
- 63 Flunarizine
- 64 Frovatriptan
- 65 Gabapentin
- 66 Galantamine
- 67 Glatiramer Acetate
- 68 Guanfacine
- 69 Haloperidol
- 70 Heparin
- 71 Indomethacin
- 72 Interferon-Β
- 73 Intravenous Immunoglobulin (Ivig)
- 74 Lacosamide
- 75 Lamotrigine
- 76 Levetiracetam
- 77 Levodopa and Carbidopa
- 78 Levomilnacipran
- 79 Lidocaine
- 80 Lithium
- 81 Mannitol
- 82 Meclizine
- 83 Memantine
- 84 Metaxalone
- 85 Methocarbamol
- 86 Methotrexate
- 87 Methylergonovine
- 88 Metoclopramide
- 89 Mexiletine
- 90 Milnacipran
- 91 Mirtazapine
- 92 Mitoxantrone
- 93 Modafinil
- 94 Mycophenolate Mofetil
- 95 Nabiximols
- 96 Naratriptan
- 97 Natalizumab
- 98 Netupitant/Palonosetron
- 99 Nimodipine
- 100 Nortriptyline
- 101 Olanzapine
- 102 Ondansetron
- 103 Oxcarbazepine
- 104 Penicillamine
- 105 Perampanel
- 106 Phenobarbital
- 107 Phenytoin and Fosphenytoin
- 108 Pizotifen
- 109 Pramipexole
- 110 Prednisone
- 111 Pregabalin
- 112 Primidone
- 113 Prochlorperazine
- 114 Promethazine
- 115 Propranolol
- 116 Pyridostigmine
- 117 Quetiapine
- 118 Quinine Sulfate
- 119 Ramelteon
- 120 Rasagiline
- 121 Reserpine
- 122 Riluzole
- 123 Rituximab
- 124 Rivaroxaban
- 125 Rivastigmine
- 126 Rizatriptan
- 127 Ropinirole
- 128 Rotigotine Transdermal System
- 129 Rufinamide
- 130 Selegiline
- 131 Sodium Oxybate
- 132 Sumatriptan
- 133 Suvorexant
- 134 Tasimelteon
- 135 Temozolomide
- 136 Teriflunomide
- 137 Tetrabenazine
- 138 Tiagabine
- 139 Timolol
- 140 Tizanidine
- 141 Topiramate
- 142 Trientine Hydrochloride
- 143 Trihexyphenidyl
- 144 Valproic Acid
- 145 Venlafaxine
- 146 Verapamil
- 147 Vigabatrin
- 148 Vilazodone
- 149 Vortioxetine Hydrobromide
- 150 Warfarin
- 151 Zolmitriptan
- 152 Zonisamide
- List of Abbreviations
- Index by Drug Name
- Index by Use
- Index by Class
Summary
THERAPEUTICS
Brands
• Pradaxa
Generic?
• No
Class
• Anticoagulant
Commonly Prescribed for
(FDA approved in bold)
• Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation (NVAF)
• Primary prevention of venous thromboembolic (VTE) events in adult patients who have undergone elective total hip or knee arthroplasty
• Prevention of stroke and systemic embolism in patients with left ventricular thrombosis
How the Drug Works
• Dabigatran etexilate is a prodrug that is rapidly converted to its active compound, dabigatran, by non-specific esterase in the plasma and liver. Dabigatran is a reversible inhibitor for factor IIa (thrombin, free and clot-bound), thereby reducing the conversion of fibrinogen into fibrin and thrombus formation. Thrombin-induced platelet aggregation is also inhibited
How Long Until It Works
• Peak concentration in 1–2 hours
If It Works
• Monitor for signs of bleeding. Assess renal function periodically as clinically indicated
If It Doesn't Work
• Correct the underlying disorder. Use a higher dose or switch to different anticoagulant
Best Augmenting Combos for Partial Response or Treatment-Resistance
• Based on RE-LY study, concomitant antiplatelet therapy has little effect on the relative advantages of dabigatran in comparison with warfarin on AF management
Tests
• A prolonged aPTT (> 1× control) is consistent with the presence of dabigatran, but the degree of prolongation does not correlate well with plasma concentrations. aPTT > 2 upper limit (after 12–24 hours) or thrombin time > 65 seconds may indicate greater bleeding risks. The Hemoclot thrombin clotting time is more accurate but not available in the US. aPTT < 1× control is at low risk of bleeding events
ADVERSE EFFECTS (AEs)
How the Drug Causes AEs
• Reduced coagulation due to inhibited thrombin
Notable AEs
• Bleeding and GI events (e.g., diarrhea, dyspepsia, abdominal pain, hemorrhage)
• Compared with warfarin, dabigatran has lower rates of intracranial bleeding and life-threatening bleeding, but higher GI bleeding
- Type
- Chapter
- Information
- Essential NeuropharmacologyThe Prescriber's Guide, pp. 136 - 139Publisher: Cambridge University PressPrint publication year: 2015