Home Forums Other Specialities Therapeutics DABIGATRAN- NEWER ANTICOAGULANT

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      Anonymous
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      Dabigatran etexilate (Pradaxa, Boehringer Ingelheim; hereafter referred to as
      dabigatran) is an orally administered anticoagulant that inhibits the thrombin
      enzyme.

      Dabigatran has a UK marketing authorisation for the ‘prevention of
      stroke and systemic embolism

      in adult patients with nonvalvular atrial
      fibrillation with one or more of the following risk factors:

      previous stroke, transient ischaemic attack, or systemic embolism

      left ventricular ejection fraction below 40%

      symptomatic heart failure of New York Heart Association (NYHA) class 2 or above
      age 75 years or over

      age 65 years or over with one of the following: diabetes mellitus, coronary artery
      disease, or hypertension’.

      The summary of product characteristics states that the recommended daily
      dose of dabigatran is 300 mg taken as one 150 mg capsule twice daily.
      Therapy is continued long term.

      For patients aged 75–80 years, a dose of
      220 mg taken as one 110 mg capsule twice daily can be considered at the
      discretion of the physician for individual patients whose thromboembolic risk is
      low and bleeding risk is high.

      Patients aged 80 years or older should be treated
      with a daily dose of 220 mg taken as one 110 mg capsule twice daily because
      of the increased risk of bleeding in this population.

      Dabigatran is contraindicated in people with severe renal impairment, active
      clinically significant bleeding, organic lesions at risk of bleeding, impairment of
      haemostasis, and hepatic impairment or liver disease expected to have an
      impact on survival.

      Concomitant treatment with systemic ketoconazole,
      cyclosporine, itraconazole or tacrolimus is also contraindicated.

      The most common adverse events in people receiving dabigatran are anaemia,
      abdominal pain, diarrhoea, dyspepsia, gastrointestinal haemorrhage,
      genitourinary haemorrhage (patients may notice blood in their urine), nausea
      and nose bleeds.
      For full details of adverse reactions and contraindications,
      see the summary of product characteristics.

      National institute of Clinical Excellence- UK.

      G Mohan.

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