Dabigatran

Sounds like 'da-be-ga-tran'

Easy-to-read medicine information about dabigatran – what it is, how to take dabigatran safely and possible side effects.

Type of medicine Also called
  • Belongs to a groups of medicines known as anticoagulants that prevent blood clots
  • Pradaxa®

What is dabigatran?

Dabigatran is an anticoagulant or blood thinner. It slows down your body’s ability to clot blood. Dabigatran is used to prevent and treat blood clots. Preventing blood clots helps lower your risk of stroke, deep vein thrombosis (DVT) and pulmonary embolism (PE). You may be prescribed dabigatran:

  • to prevent stroke if you have if you have atrial fibrillation (irregular heart beat)  atrial fibrillation increases your risk of stroke
  • to treat deep vein thrombosis (DVT), which is from blood clots that form in your blood vessels, usually in the legs or arm. Read more about DVT
  • to treat pulmonary embolism – which is from blood clots that form in the lungs. Read more about PE
  • to prevent DVTs from forming again
  • after hip or knee surgery when your risk of blood clots causing DVT or PE is increased.

Read more about anticoagulants

Dose

  • Dabigatran capsules are available in different strengths: 75 mg, 110 mg and 150 mg.
  • Your doctor or pharmacist will tell you the strength that is right for you. Your dose of dabigatran will depend on what it is being used for.
  Dose of dabigatran
To prevent stroke in people with atrial fibrillation 150 mg two times a day
To prevent clots after knee or hip surgery 220 mg once daily
To treat blood clots 150 mg two times a day
  • Your dose may be lower if you have other medical conditions such kidney problems or if you are 80 years old or more.
  • If you have had knee or hip surgery, you will need to take dabigatran for 10 to 35 days.
  • If you are taking it for other reasons, you will need to take it for longer.
  • Don't stop taking dabigatran until your doctor tells you to. Stopping too early can put you at greater risk of getting blood clots or stroke.

Always take your dabigatran exactly as your doctor has told you. The pharmacy label will tell you how much dabigatran to take, how often to take it and any special instructions.

My dose

My dabigatran dose Details
I am taking dabigatran for:

Choose the option that applies to you:

□ Atrial fibrillation
□ After hip or knee surgery, to prevent clots
□ Deep vein thrombosis (DVT)
□ Pulmonary embolism (PE)
□ _____________________________
My dose is:  
For how long:  
Notes:


 

How to take dabigatran

  • Swallow the capsules whole with a full glass of water so the capsule doesn't get stuck in your throat. 
  • Do not crush, chew or open the capsules. This will release all the medication at once and increase the risk of side effects.
  • You can have dabigatran with or without food.
  • Take dabigatran at the same times each day. 
  • Limit alcohol while you are taking dabigatran.
  • It is important to remember to take dabigatran and fill your prescription on time. If you miss a dose:
    • Within 6 hours: take your missed dose and then continue your regular dosing
    • More than 6 hours: skip the dose and take the next dose at the usual time
  • Do not take a double dose – this increases your risk of bleeding.

Special instructions

  • Extra care is needed when taking dabigatran because it can cause bleeding. 
  • Avoid new tattoos and piercings or having body massages while taking dabigatran; these things may cause bruising and bleeding.
  • Do not store dabigatran in a pill box or medication reminder box. It must be kept tightly closed in the original package to protect it from moisture.
  • It is important to let health professionals know that you are taking dabigatran, including your dentist, pharmacist, podiatrist and nurse. You may need to stop using this medicine for several days before having surgery, dental appointments or medical tests. 

Precautions – before taking dabigatran

  • Do you have problems with your kidneys or liver?
  • Are you pregnant or breastfeeding?
  • Have you ever had a stomach ulcer or bleeding in your brain?

If so, it’s important that you tell your doctor before you start taking dabigatran. Sometimes a medicine isn’t suitable for a person with certain conditions or taking other medicines, or it can only be used with extra care.

Possible side effects

Like all medicines, dabigatran can cause side effects, although not everyone gets them. Common side effects include nausea (feeling sick), indigestion, tummy cramps and headache. These may go away with time. Tell your doctor if troublesome.

Increased risk of bleeding

Dabigatran increases your risk of bleeding. You might bleed or bruise more easily while you are taking dabigatran.

Injuries or falls

Be careful when doing things that may cause bruising and bleeding, such as shaving, clipping your fingernails, brushing and flossing your teeth or playing sports. Avoid getting new tattoos and piercings. Minor bleeding should usually stop on its own. If you have a fall or hurt your head or body, get medical attention immediately, even if you feel okay.

Signs of severe bleeding

If you have any of the following signs of bleeding, contact your doctor immediately or ring Healthline for free 24 hour health advice on 0800 611 116:

  • becoming pale, very weak and tired, or short of breath
  • any bleeding from your gums, cuts or nosebleeds that won’t stop
  • blood in the stools (poo) – black, tarry stools
  • blood in the urine (wee) – pink, red or brown-coloured urine
  • heavy periods (menstrual bleeding)
  • coughing up blood or vomit that looks like coffee grounds.

Interactions

Dabigatran should not be taken with some other medications and herbal supplements, so always check with your doctor or pharmacist before starting dabigatran or before starting any new medicines. Also check with a pharmacist before taking:

  • over-the-counter anti-inflammatories such as diclofenac (e.g. Voltaren Rapid), ibuprofen (e.g. Nurofen), naproxen (e.g. Naprogesic)
  • herbal extracts such as garlic, ginkgo or ginseng.

Taking these together with dabigatran may increase your risk of bleeding and should be avoided.

Learn more

The following links have more information on dabigatran:

Dabigatran (Māori) New Zealand Formulary Patient Information
Pradaxa Medsafe Consumer Information Sheet 

References

  1. The safe and effective use of dabigatran and warfarin in primary care BPAC, NZ, 2017
  2. An update on managing patients with atrial fibrillation BPAC, NZ, 2017
  3. Dabigatran etexilate New Zealand Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 05 Aug 2018