Dabigatran
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In medicine, dabigatran is an anticoagulant that is a direct thrombin inhibitor[1] Unlike warfarin, is dabigatran is administered in fixed doses without the need for coagulation monitoring.
Pharmacology
Administration
Dabigatran is given orally and reaches peak plasma concentrations within 0.5-2 hours.[2]
Distribution
Metabolism
Excretion
Dabigatran is renally excreted.
Toxicity
Drug toxicity includes elevation in liver function tests.[2]
Clinical uses
Atrial fibrillation
| Intervention | Outcomes | ||
|---|---|---|---|
| Stroke or systemic embolism | Major bleeding | Mortality | |
| Dabigatran 110 mg twice daily | 1.53% | 2.71%† | 3.75% |
| Dabigatran 150 mg twice daily | 1.11%† | 3.11% | 3.64% |
| Warfarin | 1.69% | 3.36% | 4.13% |
| † p < 0.05 as compared to warfarin group | |||
In 2009, dabigatran, a direct thrombin inhibitors, was compared to warfarin in the RE-LY randomized controlled trial for the treatment of atrial fibrillation.[3]
Deep venous thrombosis
Dabigatran given 150 mg orally twice a day was as effective as warfarin for the treatment of deep venous thrombosis in the RE-COVER randomized controlled trial.[4]
References
- ↑ Anonymous (2024), Dabigatran (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Baetz BE, Spinler SA (2008). "Dabigatran etexilate: an oral direct thrombin inhibitor for prophylaxis and treatment of thromboembolic diseases.". Pharmacotherapy 28 (11): 1354-73. DOI:10.1592/phco.28.11.1354. PMID 18956996. Research Blogging.
- ↑ 3.0 3.1 Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A et al. (2009). "Dabigatran versus Warfarin in Patients with Atrial Fibrillation.". N Engl J Med 361 (12): 1139-1151. DOI:10.1056/NEJMoa0905561. PMID 19717844. Research Blogging.
- ↑ Schulman, Sam; Clive Kearon, Ajay K. Kakkar, Patrick Mismetti, Sebastian Schellong, Henry Eriksson, David Baanstra, Janet Schnee, Samuel Z. Goldhaber, the RE-COVER Study Group (2009-12-06). "Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism". N Engl J Med: NEJMoa0906598. DOI:10.1056/NEJMoa0906598. Retrieved on 2009-12-06. Research Blogging.