The new oral anticoagulant Pradaxa® (Dabigatran) is increasingly being used as an alternative to warfarin. A number of practical management questions are now encountered by the physician, pharmacist, or other health care professional taking care of the patient on Pradaxa®, such as (a) dosing in renal impairment, (b) conversion of a patient on warfarin to Pradaxa®, (c) discontinuation of Pradaxa® at times of surgery, dental work, colonoscopy, or other procedures, or (d) management of bleeding on Pradaxa®. These issues may best be addressed in a health care system by the establishment of a structured treatment algorithm/guide/help for the whole hospital or physician practice. As an example, here is the document that we have established for our institution, the University of North Carolina (UNC) Health Care System. The reader is welcome to (a) take the document and modify it to fit his/her institution/practice’s need or (b) use as a clinical reference for management issues. Also, a detailed discussion of various Pradaxa® issues can also be found in this Clot Connect blog:
- Pradaxa® use in patients with DVT or PE: click here
- Management of major bleeding on Pradaxa®: click here
- Pradaxa® interruption for procedures and surgeries: click here
Disclosure: I have no financial conflict of interest relevant to this educational post.
Last updated: May 1st, 2012
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