A new anticoagulant therapy was recently approved for UHS formulary by the Pharmacy and Therapeutics Committee. Dabigatran (commercially sold as Pradaxa ) was approved by the FDA as an oral anticoagulant to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF).
Dabigatran is a direct thrombin (factor lla) inhibitor. The RE-LY trial suggests that dabigatran offers similar efficacy in stroke prevention as warfarin (Coumadin ). Dabigatran has a quick onset of action. Blood levels peak in 1-2 hours and reach a steady-state in 2-3 days. It requires twice daily dosing to maintain steady blood levels.
Dabigatran does not require laboratory monitoring, such as INR. However, there is no antidote for reversing the effect, and therapy should be stopped if a patient has active pathological bleeding. If you have questions regarding this new drug, please contact the Pharmacy Department.