Title:Dabigatran - A New Chapter in Anticoagulation
Volume: 10
Issue: 2
Author(s): Shameer Ahmed, Vadim Levin, Robert Malacoff and Matthew W. Martinez
Affiliation:
Keywords:
Anticoagulation, atrial fibrillation, BISTRO trial, chemical structure, dabigatran, diract thrombin inhibitors,
PETRO trial, pharmacodynamics, pharmacokinetics, Re-Ly trial, RECOVER trial, stroke warfarin
Abstract: For the last 60 years warfarin has been the cornerstone for chronic anticoagulation in prevention of ischemic
strokes and systemic embolization. Warfarin therapy has several limitations including frequent monitoring and various
food and significant drug interactions, which make it a less than ideal chronic oral anticoagulant. The continued search for
safe, effective, medications with predictable pharmacokinetic profiles has led to newer alternatives. Dabigatran is a potent
reversible, competitive direct thrombin inhibitor which is available as the prodrug, Dabigatran etexilate. It was first
approved in Europe and recently in October 2010, the US food and drug administration (FDA) has approved the use of
this novel oral anticoagulation for prevention of stroke in those with non valvular atrial fibrillation. This review will cover
the chemical structure, mechanism of action, pharmacokinetic profile, clinical trials, dosage, clinical implication and
adverse effects of dabigatran.
