title: Dabigatran for the prevention and treatment of thromboembolic disorders.
abstract: Dabigatran, an oral direct thrombin inhibitor, was the first of a new class of drugs referred to as non-vitamin K oral anticoagulants. Dabigatran is better than warfarin for stroke prevention in non-valvular atrial fibrillation (dose of 150 mg twice a day), non-inferior to enoxaparin for venous thromboembolism prevention after orthopedic surgery and non-inferior to warfarin in preventing recurrence after acute venous thromboembolism. The safety profile is similar to standard anticoagulants, with significant reduction observed in intracranial hemorrhage. Other advantages include a rapid onset of action and a predictable pharmacokinetic profile, allowing a fixed-dose regimen without the need for routine anticoagulation monitoring. In the event of bleeding, general support measures are recommended and if severe, the use of non-specific hemostatic agents such as prothrombin complex concentrates and recombinant factor VIIa must be considered. A specific reversal agent (idarucizumab) is in development.
authors.affiliation: Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
authors.forename: Andres
authors.initials: A
authors.lastname: Enriquez
authors.forename: Adrian
authors.initials: A
authors.lastname: Baranchuk
authors.forename: Damian
authors.initials: D
authors.lastname: Redfearn
authors.forename: Christopher
authors.initials: C
authors.lastname: Simpson
authors.forename: Hoshiar
authors.initials: H
authors.lastname: Abdollah
authors.forename: Kevin
authors.initials: K
authors.lastname: Michael
mesh_terms: D000818:Animals; D000991:Antithrombins / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D000069604:Dabigatran / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000453:epidemiology; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013923:Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
chemical_list: D000991:Antithrombins; D000069604:Dabigatran
keywords: NOACs; dabigatran; new oral anticoagulants; warfarin