Dabigatran is a type of anticoagulant used to prevent or treat harmful blood clots.
The main side-effect of all anticoagulants is bleeding. If you experience any unusual bleeding, speak with your doctor.Do not take anti-inflammatory painkillers (such as aspirin or ibuprofen) while you are on dabigatran.
|Type of medicine||An anticoagulant medicine|
|Used for||To prevent or treat harmful blood clots|
Sometimes, harmful blood clots can form in your veins and cause a blockage. This is more likely to happen if you are having certain types of surgery, or if you have a fast irregular heartbeat. Dabigatran works by preventing your blood from clotting as quickly or as effectively as normal. It does this by interfering with a substance in your blood which is involved in the development of blood clots, called thrombin. This means that it can be used to treat unwanted blood clots that have developed in your legs or lungs. It can also be given to prevent blood clots from forming in, for example, your legs, lungs, brain or heart.
You may have been prescribed dabigatran to treat a blood clot causing deep vein thrombosis or pulmonary embolism. Alternatively, you may have been prescribed it to help protect against blood clots if you are having hip or knee surgery, or if you have a certain type of irregular fast heartbeat known as atrial fibrillation.
For many years, a medicine called warfarin has been commonly used to treat blood clots like these and also to help protect against them. However, people who take warfarin need to have regular blood tests to measure how quickly their blood clots. This often means that the dose of warfarin can change quite frequently. Dabigatran works in a slightly different way to warfarin, so people who take dabigatran do not need to have regular blood tests (although occasional blood tests may still be needed).
Before taking dabigatran
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking dabigatran it is important that your doctor knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If your kidneys do not work well or if you have problems with the way your liver works.
- If you have any medical problems that may increase your risk of bleeding, or if you are currently bleeding.
- If you have been told you have a condition called antiphospholipid syndrome.
- If you are taking any other prescribed medicines. You must also tell your doctor if you are taking any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take dabigatran
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about dabigatran and will provide you with a full list of the side-effects which you may experience from taking it.
- Take dabigatran exactly as your doctor tells you to. Your doctor or pharmacist will tell you how many capsules to take each day, and how often to take them. Your dose could be one or two capsules, taken once or twice a day. Your dosage information will be printed on the label of the pack to remind you.
- Try to take dabigatran at the same time(s) each day, as this will help you to remember to take your doses regularly. Swallow the capsules whole with a drink of water. Do not open the capsule to help you swallow as this will increase the risk that you will experience side-effects such as bleeding. You can take dabigatran either before or after meals.
- If you forget to take a dose, you can still take it up to six hours before you are due to take your next dose. If it is less than six hours before you need to take your next dose, do not take the missed dose. Miss this dose out completely but remember to take your next dose of dabigatran as normal. Do not take two doses at the same time to make up for the missed dose. If in doubt, speak with your pharmacist or doctor.
- Do not take more doses than your doctor has recommended for you. If this happens by accident, contact your doctor straightaway as you may be at risk of bleeding.
Getting the most from your treatment
- Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress. You may need to have an occasional blood test if you are taking dabigatran over a period of time.
- If you have had knee surgery, you will be asked to take dabigatran once each day for a total of 10 days. If you have had hip surgery, you will be asked to take dabigatran once each day for 4-5 weeks. If you are taking it for any other reason, you will be asked to take it twice a day for a period of time.
- There are several strengths of dabigatran capsule available. Each time you collect a fresh supply, it is a good idea to check that the strength of the capsules is what you are expecting. If you are at all unsure, your pharmacist will be able to advise you further.
- If you buy any medicines 'over the counter', always check with a pharmacist that they are safe to take with dabigatran. This is because some medicines (such as anti-inflammatory painkillers like aspirin and ibuprofen) can increase the risk of bleeding and should be avoided.
- If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Can dabigatran cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with dabigatran. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Bleeding (such as nosebleeds)||If the bleeding continues or becomes troublesome, let your doctor know|
|Feeling sick, indigestion, diarrhoea, tummy (abdominal) pain||See your doctor if this persists|
|Changes to laboratory test results on liver function||Your doctor will check for this|
Important: if you experience any unusual bleeding, speak with your doctor straightaway or go to your local accident and emergency department.
If you experience any other symptoms which you think may be due to dabigatran, speak with your doctor or pharmacist for further advice.
How to store dabigatran
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Pradaxa® 150 mg hard capsules; Boehringer Ingleheim, The electronic Medicines Compendium. Dated November 2016.
British National Formulary 74th Edition (Sep 2017); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.