Dabigatran for atrial fibrillation patients can lower risk of stroke and performs better than similar medications used for the same purpose. This medication does not treat the atrial fibrillation itself, instead addressing known complications of the heart condition. Patients with atrial fibrillation experience an abnormal heart rhythm that can cause a variety of problems, including an elevated chance of stroke and embolism. For this reason, a doctor may wish to treat the patient with an anticoagulant medication as a protective measure.
Historically, patients who needed medication to prevent stroke took warfarin, and it is still widely recommended for this purpose in many settings. This anticoagulant medication can be very effective, although it does carry some risks. Patients may be more likely to experience uncontrolled bleeding while on the drug and require careful monitoring to check levels of the medication in their blood. Patients who take dabigatran for atrial fibrillation experience better outcomes in some cases than those who use warfarin to control clotting.
In controlled studies on populations using these medications, research found that the risks of embolism and stroke tended to be lower on dabigatran for atrial fibrillation. The exact differences between this drug and warfarin depended on the dosage and the patient's prior history. Patient outcomes at higher doses can be similar. If a patient has an elevated risk of stroke or embolism for other reasons, the difference between dabigatran and warfarin may be minimal.
There are some concerns about using dabigatran for atrial fibrillation. One issue is the cost, which can be higher than that of other anticoagulants and can be a limiting factor for some patients. Another concern is the higher incidence of gastrointestinal side effects. These can cause discomfort and may make it harder for patients to adhere to the treatment regimen. Furthermore, the medication is metabolized in the kidneys, which can be an issue for patients with preexisting kidney disease.
Before prescribing dabigatran for atrial fibrillation, the doctor may request a workup to check for underlying medical issues that could become a problem. It may be possible to adjust the dosing to compensate for concerns while still offering patients the benefit of the drug. If side effects do develop, it is important to report them to the doctor. It may be necessary to switch to a different medication or a lower dose if the side effects become severe or pose a risk to the patient's health.