Dabigatran is a medication used to prevent dangerous blood clots in patients with atrial fibrillation. Like other drugs in its class, it makes the blood thinner and interferes with the body’s ability to produce thrombin. This makes it difficult for blood to clot, and though this reduces the risk of stroke and systemic embolism in certain patients, it can also cause uncontrolled bleeding.
The two conditions that dabigatran is used to prevent are systemic embolism and stroke. Systemic embolism occurs when a blood clot becomes lodged in an artery, cutting off blood flow. This condition can occur within any of the arteries in the body, though it is more dangerous when it occurs in a large blood vessel. Strokes can be caused by a blood clot that travels into the major arteries leading to the brain. If such a clot gets trapped, it can block the artery and prevent blood from reaching a portion of the brain.
An anticoagulant, dabigatran prevents stroke and systemic embolism by keeping blood clots from forming. Anticoagulants interfere with the enzyme thrombin, which releases a substance that helps platelets in the blood stick together. This interference can prevent thrombin from forming, prevent it from functioning, or both.
While anticoagulants are useful for preventing blood clots, hampering the body’s ability to form these clots can lead to excessive bleeding. Patients with a history of serious bleeding may be at risk if they are given this type of medication. Doctors evaluate the use of anticoagulant drugs, such as dabigatran, on a case by case basis. Patients with a surgery scheduled may be advised to stop treatment with this medication before their surgery.
The United States Food and Drug Administration (FDA) approved dabigatran for preliminary use in 2010. It is similar to another drug currently on the market called warfarin. Studies overseen by the FDA showed that dabigatran is more effective at preventing stroke and systemic embolism than this other medication, which prompted its initial approval. Both of these medications pose an equal risk of internal bleeding, which can be considered an acceptable risk if the chances of developing a life-threatening blood clot are high.
There are two dosages of dabigatran that have been approved for use by the FDA. Most patients are prescribed 150 mg to take twice a day. Patients with impaired renal function may be given half of that dose and monitored for blood loss. The lower dose lessens the risk of gastrointestinal problems, and people with such problems may be at increased risk of internal bleeding.
