Archive for the ‘Pradaxa – dabigatran’ Category
If you are considering to start therapy with the new oral “blood thinner” Pradaxa®, there are a few safety nets that your local hospital and physician may want to establish to make therapy as safe as possible for you. Issues to be addressed are (a) dosing, (b) management of major bleeding, (c) interruption of therapy for surgery, dental procedures, or other procedures, d) what to do if you missed a dose, and (e) what to do if the pill box has been left open for too long.
These issues are probably best addressed by the establishment of a treatment algorithm/guide/help for the whole hospital or physician practice. As an example, attachedthat we developed for our institution, the University of North Carolina (UNC) Health Care System. Your physicians and pharmacists are free to (a) take the document and modify it to fit their institution/practice or (b) use it as a clinical reference for management issues.
For Health Care Professionals: This same post, written for health care professionals, is posted here.
Disclosure: I have no financial conflict of interest relevant to this educational post.
Last updated: May 1st, 2012
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When to stop the drug – General comments
If you are on Pradaxa® (Dabigatran) you may need interruption of therapy for dental work, a medical procedure such as colonoscopy, or minor or major surgical procedure. As to when exactly to take the last dose of Pradaxa® before the procedure depends on (a) how big a procedure is planned and how much bleeding is expected to occur with it, and (b) whether a person is at high or low risk for a blood clot if he/she is off “blood thinners” for a few days. Read the rest of this entry »
Major and life-threatening bleeding is expected to occur in some patients treated with Pradaxa® (=Dabigatran). The question will then urgently arise how to best treat such catastrophic bleeding. As there have been no data published on this topic in the peer-reviewed medical literature, we don’t know how to best manage a patient with major and life-threatening bleeding Read the rest of this entry »
The new oral “blood thinner” Pradaxa® (=Dabigatran) was approved by the FDA on October 20th, 2010 (ref 1 and 2). This is huge news! This is the first oral blood thinner alternative to warfarin (=Coumadin®, Jantoven®). At this point, Pradaxa® is only FDA approved for use in patients with irregular heart beat (= atrial fibrillation = a. fib). It is not approved yet for patients with DVT and PE. Read the rest of this entry »