Saturday 20 March 2010

dabigatran



da-bye-GAT-ran e-TEX-i-late MES-i-late


Commonly used brand name(s)

In the U.S.


  • Pradaxa

Available Dosage Forms:


  • Capsule

Pharmacologic Class: Dabigatran Etexilate


Uses For dabigatran


Dabigatran is used to decrease the risk of stroke and blood clots in patients with a serious heart rhythm problem called nonvalvular atrial fibrillation. It works by preventing harmful clots from forming in the blood vessels.


dabigatran is available only with your doctor's prescription.


Before Using dabigatran


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dabigatran, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to dabigatran or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Appropriate studies have not been performed on the relationship of age to the effects of dabigatran in the pediatric population. Safety and efficacy have not been established.


Geriatric


Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dabigatran in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving dabigatran.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dabigatran, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using dabigatran with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Abciximab

  • Acenocoumarol

  • Alteplase, Recombinant

  • Anistreplase

  • Argatroban

  • Aspirin

  • Bivalirudin

  • Bromfenac

  • Celecoxib

  • Cilostazol

  • Clopidogrel

  • Dalteparin

  • Danaparoid

  • Desirudin

  • Diclofenac

  • Diflunisal

  • Dipyridamole

  • Dronedarone

  • Drotrecogin Alfa

  • Enoxaparin

  • Eptifibatide

  • Etodolac

  • Flurbiprofen

  • Fondaparinux

  • Heparin

  • Ibuprofen

  • Ibuprofen Lysine

  • Indomethacin

  • Ketoconazole

  • Ketoprofen

  • Ketorolac

  • Lepirudin

  • Magnesium Salicylate

  • Mefenamic Acid

  • Meloxicam

  • Nabumetone

  • Naproxen

  • Nepafenac

  • Oxaprozin

  • Phenindione

  • Phenprocoumon

  • Piroxicam

  • Prasugrel

  • Protein C, Human

  • Reteplase, Recombinant

  • Rifampin

  • Rivaroxaban

  • Salsalate

  • St John's Wort

  • Streptokinase

  • Sulfinpyrazone

  • Sulindac

  • Tenecteplase

  • Ticlopidine

  • Tinzaparin

  • Tirofiban

  • Tolmetin

  • Urokinase

  • Warfarin

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.


Other Medical Problems


The presence of other medical problems may affect the use of dabigatran. Make sure you tell your doctor if you have any other medical problems, especially:


  • Bleeding, active—Should not be used in patients with this condition.

  • Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of dabigatran


Take dabigatran exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. Also, do not stop using dabigatran without checking first with your doctor.


dabigatran comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor if you have any questions.


You may take dabigatran with or without food.


Swallow the capsules whole. Do not break, crush, or chew them. Do not open the capsules and sprinkle the pellets over food or into liquids.


If you are taking another medicine to thin the blood, (e.g., heparin, warfarin, or Coumadin®), your doctor will give you very specific instructions about how to switch to dabigatran. Carefully follow the instructions and ask your doctor if you have any questions.


Dosing


The dose of dabigatran will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dabigatran. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For oral dosage form (capsules):
    • For prevention of stroke and blood clots:
      • Adults—75 to 150 milligrams (mg) two times a day.

      • Children—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of dabigatran, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


If you have less than 6 hours before your next scheduled dose, skip the missed dose and go back to your regular dosing schedule.


Storage


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Ask your healthcare professional how you should dispose of any medicine you do not use.


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Keep your medicine in the original package (blister package or bottle) until you are ready to use it. Do not store the capsules in any other container (e.g., pill boxes or pill organizers). After you open a bottle for the first time, you must take all of the capsules within 4 months. If you have not used the capsules within 4 months, you must dispose of the remaining capsules and start a new bottle.


Precautions While Using dabigatran


It is very important that your doctor check your progress at regular visits to make sure that dabigatran is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.


Make sure any doctor who treats you knows that you are using dabigatran. You may need to stop using dabigatran for several days before having surgery, including dental procedures.


You may bleed and bruise more easily while you are using dabigatran. Be extra careful to avoid injuries. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Gently brush and floss your teeth. Be careful when using sharp objects, including razors and fingernail clippers. Avoid picking your nose. If you need to blow your nose, blow it gently.


Check with your doctor right away if you have any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; headache, dizziness, or weakness; pain, swelling, or discomfort in a joint; pinpoint red spots on your skin; unusual nosebleeds; or unusual vaginal bleeding that is heavier than normal. These may be signs of bleeding problems.


Check with your doctor right away if you have stomach pain or upset, nausea, heartburn, or indigestion while you are taking dabigatran.


Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


dabigatran Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor immediately if any of the following side effects occur:


More common
  • Acid or sour stomach

  • belching

  • black, tarry stools

  • bloody stools

  • constipation

  • diarrhea

  • heartburn

  • indigestion

  • nausea

  • pain or burning in the throat

  • stomach discomfort, upset, burning, or pain

  • vomiting

  • vomiting of blood or material that looks like coffee grounds

Rare
  • Cough

  • difficulty with swallowing

  • dizziness

  • fainting or loss of consciousness

  • fast heartbeat

  • fast or irregular breathing

  • hives or welts

  • itching

  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

  • redness of the skin

  • shortness of breath

  • skin rash

  • tightness in the chest

  • trouble with breathing

  • unusual tiredness or weakness

  • wheezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: dabigatran side effects (in more detail)



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More dabigatran resources


  • Dabigatran Side Effects (in more detail)
  • Dabigatran Dosage
  • Dabigatran Use in Pregnancy & Breastfeeding
  • Dabigatran Drug Interactions
  • Dabigatran Support Group
  • 40 Reviews for Dabigatran - Add your own review/rating


  • Dabigatran MedFacts Consumer Leaflet (Wolters Kluwer)

  • Pradaxa Prescribing Information (FDA)

  • Pradaxa Consumer Overview



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