Direct Thrombin Inhibitors
Direct thrombin inhibitors prevent cleavage of fibrinogen to fibrin, and are therefore very effective anticoagulants.
| Property | Dabigatran |
|---|---|
| Class | NOAC |
| Uses | VTE prophylaxis, AF |
| Presentation | 75/110mg Capsules |
| Route of Administration | PO |
| Dosing | VTE: 220mg daily, AF: 150mg BD |
| Absorption | 6.5% bioavailability |
| Distribution | 35% protein bound |
| Metabolism | Prodrug - activated by plasma and hepatic esterases |
| Elimination | Renal elimination of active drug |
| Haeme | Haemorrhage |
| Immune | Allergy |
| Other | Significant interactions with amiodarone, quinidine, St. John's Wort, as well as other anticoagulant and antiplatelet agents. Dialysable. Potentially reversible with idarucizumab. |
References
- Smith S, Scarth E, Sasada M. Drugs in Anaesthesia and Intensive Care. 4th Ed. Oxford University Press. 2011.
- Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.