Dabigatran

What it is

Dabigatran is an oral anticoagulant that directly inhibits thrombin, the enzyme that converts fibrinogen to fibrin at the final step of clotting. It is used to treat and prevent thrombosis and to lower stroke risk in atrial fibrillation. The capsule contains pellets whose tartaric acid core, coated with the drug, supplies the acidic microenvironment that absorption depends on.

Used for

• Thrombosis
• Stroke prevention

What to know while taking it

The capsule is taken with food, swallowed whole rather than opened, and kept in its original blister until use, because the pellets take up moisture and lose potency in a pill organiser. Acetylsalicylic acid and ibuprofen, which act on platelets, and anticoagulants such as warfarin raise bleeding risk when added, so they are not combined without a doctor's decision. Dabigatran is cleared largely by the kidneys, which makes creatinine and eGFR the values that matter most, alongside hemoglobin as a marker of unnoticed blood loss. Stomach upset is common early on and food eases it; any planned surgery or dental work is discussed with the operator in advance.

When to see a doctor

Bleeding that will not stop, black or tarry stools, blood in urine or vomit, or widespread unexplained bruising call for a doctor. Sudden severe headache, confusion or weakness, or any head injury while on treatment needs immediate care.

Worth knowing

• Raises bleeding risk
• Keep in the original blister
• Tell the surgeon before any operation

Markers to watch

• Hemoglobin
• Creatinine
• eGFR