Dabigatran

What is dabigatran?

Dabigatran (brand name Pradaxa) is an anticoagulant, or blood thinner. It helps prevent the formation of harmful blood clots by inhibiting a key clotting factor called thrombin. It belongs to a group of medicines known as direct oral anticoagulants (DOACs). Dabigatran is available on prescription only[1]. 

How does dabigatran work?

Dabigatran is prescribed for the prevention and treatment of various clot-related conditions, including[1]: 

• To prevent stroke and systemic embolism in people with non-valvular atrial fibrillation (AF)  

• Deep vein thrombosis (DVT) and pulmonary embolism (PE), and to prevent them from coming back 

• To prevent blood clots following hip or knee replacement surgery 

How does dabigatran work?

Dabigatran works by blocking thrombin, an enzyme that plays a key role in the blood clotting process. By doing this, it reduces clot formation and reduces the risk of dangerous clots developing in the bloodstream[1].  

Who can take dabigatran?

Most adults and children can take dabigatran. However, you should speak to a doctor first if you[1]: 

• Are pregnant or trying to conceive 

• Have severe kidney or liver problems 

• Have active bleeding or an increased risk of bleeding, a stomach ulcer, or have recently had spinal surgery 

• Have antiphospholipid syndrome 

• Have had heart valve replacement surgery  

• Are allergic to dabigatran or any of the other ingredients listed as part of the medicine 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of dabigatran?

Dabigatran is available as 75mg, 110mg, and 150mg capsules. It is also available in 20mg, 30mg, 40mg, 50mg, 110mg and 150mg  granules sachets for children under 12 years of age until they can swallow capsules. The dose depends on your condition[1]: 

• For atrial fibrillation or treating clots, the usual dose is150mg twice daily 

• After a hip or knee joint replacement surgery, the usual dose is 110mg twice daily 

• Lower doses may be used in older adults or those with reduced kidney function 

• Dose in children will depend on age and bodyweight.  

How do you take dabigatran?

You should always take the medicine as your doctor prescribes, dabigatran is usually taken[1]: 

• Twice a day, with or without food (may be given once a day after surgery) 

• At the same times each day 

• With water – capsules must be swallowed whole (do not crush or chew) 

Can you stop taking dabigatran?

Do not stop taking dabigatran without speaking to your doctor or pharmacist. Stopping suddenly increases your risk of stroke or blood clots. Your doctor may advise pausing treatment before certain procedures[1].  

What do you do if you take too much dabigatran?

An overdose increases the risk of serious bleeding. If this happens[1]: 

• Call NHS 111 or go to A&E immediately 

• Bring your medication packaging with you 

• Do not drive yourself – call 999 if necessary  

What do you do if you forget to take dabigatran?

If you miss a dose[1]: 

• For atrial fibrillation or a blood clot – take the forgotten dose as soon as you remember. If your next dose is due in less than 6 hours, skip the forgotten dose and take your next dose at the usual time 

• For hip or knee joint replacement – skip the forgotten dose completely and then take your next dose when it's due 

• Never take two doses at once and never take an extra dose to make up for a forgotten one 

How do you store dabigatran?

Keep dabigatran in its original packaging, in a dry place out of children’s reach. The manufacturer recommends that capsules be kept in their original packaging at room temperature and not popped out into pill boxes or organisers. Keep an eye on the expiry date – do not use after expiry[1].  

What medicines can’t you take with dabigatran?

Dabigatran may interact with several medicines and supplements. Use caution or avoid[1]: 

• Other anticoagulants (e.g., warfarin, enoxaparin, rivaroxaban) 

• Antiplatelet drugs (e.g., aspirin, clopidogrel) 

• Antifungals (e.g. ketoconazole) 

• Medicines to treat abnormal heart beats (e.g. amiodarone) 

• Immunosuppressants (e.g. tacrolimus, cyclosporine) 

• NSAIDs (e.g., ibuprofen) 

• St John’s Wort (herbal remedy) 

• Some HIV medicine (e.g. ritonavir) 

• Some antidepressants called SSRIs or SNRIs 

• Some antibiotics (e.g. clarithromycin or rifampicin) 

• Some antiepileptics (e.g. carbamazepine or phenytoin) 

You can safely take paracetamol for pain relief. Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of dabigatran?

Common side effects (in more than 1 in 100 people) include[1]: 

• Bleeding (e.g., nosebleeds, bruising, heavy periods) 

• Indigestion or stomach pain 

• Anaemia (tiredness, pale skin) 

• Dizziness or light-headedness 

Serious side effects include[1]: 

• Coughing or vomiting blood 

• Black or bloody stools 

• Severe headache or dizziness 

• Blood in urine or unexplained bruising 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

 If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about dabigatran

How long does dabigatran take to work? 
It starts working within a few hours[1]. 

Are there alternatives to dabigatran? 
Yes – alternatives include apixaban, rivaroxaban, edoxaban, and warfarin[1]. 

Do I need an alert card? 
Yes – carry a patient alert card at all times. You should receive one as part of the medication packaging. . Please contact your doctor or pharmacist should you require one[1].  

Can I take it with food? 
Yes – food does not affect how it works[1]. 

Can I drink alcohol with dabigatran? 
Yes, in moderation. Avoid heavy drinking as it increases bleeding risk[1]. 

For the official NHS guide for Dabigatran, visit their website.