Dabigatran comes in capsule form and should be taken by mouth, usually twice a day. Here’s how to use it:
- Take with or without food: You can take dabigatran with or without food. However, taking it with food may help reduce the chance of stomach upset.
- Swallow whole: Take the capsule whole—do not crush, chew, or open the capsule. This is because breaking the capsule can make the medication less effective or increase the risk of side effects.
- Take regularly: For best results, take dabigatran at the same time each day. Set a reminder to help you remember.
- Missed Dose: If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose. Do not take two doses at once.
Dabigatran works by directly blocking thrombin, an enzyme involved in the formation of blood clots. Thrombin converts fibrinogen into fibrin, a protein that helps blood clots to form. By inhibiting thrombin, dabigatran helps to:
- Prevent clot formation: By blocking thrombin, dabigatran helps to reduce the risk of clots forming in the blood vessels.
- Reduce the risk of stroke and embolism: In people with atrial fibrillation, blood clots can form in the heart and travel to the brain, causing a stroke. Dabigatran helps prevent this from happening.
- Treat existing clots: Dabigatran is also used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE), helping to dissolve clots and prevent them from getting worse.
By reducing clot formation, dabigatran helps to prevent the complications associated with blood clots, such as strokes, heart attacks, and damage to organs.
Like any medication, dabigatran can cause side effects, though not everyone will experience them. Common side effects include:
- Bleeding: Dabigatran can increase the risk of bleeding, which can be serious. Watch for signs of easy bruising, unusual bleeding, or bleeding that doesn’t stop.
- Stomach Upset: Some people may experience nausea, indigestion, or stomach pain.
- Headache: Headaches are a common side effect, although they are usually mild.
Serious side effects (which require immediate medical attention) include:
- Severe Bleeding: Symptoms may include unusual bruising, nosebleeds, blood in urine or stools, or coughing up blood.
- Heart Attack: Though rare, dabigatran has been linked to a small risk of heart attack in some patients.
- Liver Problems: Rarely, dabigatran can cause liver issues. Signs include yellowing of the skin or eyes (jaundice), dark urine, and unusual fatigue.
If you experience any of these serious side effects, stop taking dabigatran and contact your healthcare provider immediately.
Before taking dabigatran, be aware of the following warnings and precautions:
- Bleeding Risk: Dabigatran increases the risk of bleeding, which can be severe or even life-threatening. Be cautious and inform your doctor if you have a history of bleeding disorders.
- Kidney Function: Dabigatran is primarily eliminated by the kidneys. If you have kidney disease, your doctor may adjust your dose or consider an alternative treatment.
- Pregnancy and Breastfeeding: Dabigatran is not recommended during pregnancy or breastfeeding unless absolutely necessary. Speak with your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
- Discontinue Before Surgery: If you need surgery or dental work, you may need to stop taking dabigatran for a short period of time to reduce the risk of bleeding.
Always talk to your healthcare provider about your medical history, especially regarding bleeding disorders, kidney problems, or other health conditions.
Dabigatran can interact with other medications, which may either increase the risk of bleeding or affect how well the medication works. Some notable interactions include:
- Anticoagulants (Blood Thinners): Using dabigatran with other blood thinners (like warfarin or aspirin) can increase the risk of bleeding.
- Certain Antifungals, Antibiotics, and Antiviral Medications: These drugs can increase the amount of dabigatran in your body, raising the risk of side effects.
- P-glycoprotein Inhibitors: Drugs that affect a protein called P-glycoprotein (such as verapamil or amiodarone) can increase dabigatran’s concentration in your body.
Make sure to inform your doctor about all medications you are taking, including over-the-counter drugs and supplements.
The typical dosage for dabigatran is:
- Atrial Fibrillation (Stroke Prevention): 150 mg twice a day.
- DVT/PE Treatment and Prevention: 150 mg twice a day (starting dose after initial heparin therapy).
- Post-Surgery (to prevent blood clots): 110 mg once daily on the first day, followed by 220 mg once daily.
Your doctor will adjust your dose based on your specific condition, response to treatment, and any underlying health concerns.