[Medication of the month. Dabigatran etixilate (Pradaxa): an oral anticoagulant acting as a direct selective inhibitor of thrombin].
Dabigatran (Pradaxa) is a new oral, direct, selective and reversible thrombin inhibitor (factor IIa) acting as anticoagulant. Pradaxa does not require monitoring or dose adjustment, except in cases of moderate renal insufficiency or in elderly patients (>75 years old). It is currently indicated for prophylaxis against venous thromboembolism after total hip or knee replacement surgery. Pradaxa has been shown to be as effective as enoxaparin in reducing the risk of venous thromboembolism after total hip or knee replacement surgery, with a similar safety profile. The recommended dose of 220 mg is administered once-daily, starting with a half-dose 1-4 h after surgery. The total duration of treatment is 10 days for knee surgery and 28-35 days in case of hip replacement. Contrary to enoxaparin, with Pradaxa there is no risk of drug-related thrombocytopenia. Of note, this promising new anticoagulant has also shown to be more effective than warfarin for stroke prevention in patients with non-valvular atrial fibrillation and as effective as warfarin for the treatment of acute venous thromboembolism (indications not recognized yet).
Université de Liège, Responsable du Service des Soins Intensifs Cardiologiques, Service de Cardiologie, CHU de Liège, Belgique.
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Lancellotti
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Scheen
D000925:Anticoagulants / Q000494:pharmacology*; D058833:Antithrombin Proteins / Q000494:pharmacology; D019643:Arthroplasty, Replacement; D001562:Benzimidazoles / Q000494:pharmacology*; D000069604:Dabigatran; D006801:Humans; D011725:Pyridines / Q000494:pharmacology*; D054556:Venous Thromboembolism / Q000517:prevention & control
D000925:Anticoagulants; D058833:Antithrombin Proteins; D001562:Benzimidazoles; D011725:Pyridines; D000069604:Dabigatran