Abstract
Dabigatran etexilate is an oral anticoagulant that is effective in preventing embolism in patients with nonvalvular atrial fibrillation. It is a prodrug that is rapidly converted to dabigatran, a potent, reversible direct thrombin inhibitor. The plasma concentration of dabigatran reaches a peak 2 hours after administration and the drug's half-life is 14 hours. The anticoagulant activity of dabigatran is predictable and it is not necessary to monitor the clotting time. The drug is primarily eliminated by the kidneys, largely in an unaltered form. Renal failure predisposes to its accumulation. Dabigatran is not metabolized by cytochrome P450 isoenzymes and has few drug interactions. Dabigatran dose-adjustment should be considered in elderly patients and in those who have a low body weight, who are at a high risk of bleeding or who are receiving concomitant treatment with verapamil or antiplatelet agents.
Published Version
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