Pradaxa Dosage

Generic name: dabigatran
Drug class: Thrombin inhibitors

Recommended Adult Dosing

Dosage forms:  CAP: 75 mg, 110 mg, 150 mg

Thromboembolism/stroke prophylaxis

[150 mg PO bid]

Info: for non-valvular atrial fibrillation w/o mod-severe mitral stenosis or mechanical heart valve; to convert from warfarin, D/C warfarin, then start dabigatran when INR <2; to convert from other oral anticoagulants, D/C oral anticoagulant, then start dabigatran at next scheduled dose; to convert from parenteral anticoagulants, D/C parenteral anticoagulant, then start dabigatran 0-2h before next scheduled dose; consider holding tx 1-2 days before surgery or invasive procedure if CrCl >50 or 3-5 days if CrCl <50; do not open/dissolve cap

DVT/PE tx

[150 mg PO bid]

Start: ASAP after unfractionated heparin infusion D/C, or if transitioning from LMWH, give 0-2h before next LMWH dose would have been administered; Info: for use in pts initially treated w/ parenteral anticoagulant x5-10 days; consider holding tx 1-2 days before surgery or invasive procedure if CrCl >50 or 3-5 days if CrCl <50; do not open/dissolve cap

DVT/PE prophylaxis, recurrent

[150 mg PO bid]

Info: to convert from warfarin, D/C warfarin, then start dabigatran when INR <2; to convert from other oral anticoagulants, D/C oral anticoagulant, then start dabigatran at next scheduled dose; to convert from parenteral anticoagulants, D/C parenteral anticoagulant, then start dabigatran 0-2h before next scheduled dose; consider holding tx 1-2 days before surgery or invasive procedure if CrCl >50 or 3-5 days if CrCl <50; do not open/dissolve cap

DVT/PE prophylaxis, hip replacement

[220 mg PO qd x28-35 days]

Start: 110 mg PO x1 dose 1-4h postop or 220 mg PO qd on day after surgery; Info: consider holding tx 1-2 days before surgery or invasive procedure if CrCl >50 or 3-5 days if CrCl <50; do not open/dissolve cap

VTE prophylaxis, cardioversion

[150 mg PO bid]

Start: at least 3wk before cardioversion; Info: for pts w/ afib/flutter duration >48h or unknown; continue tx x4wk after procedure

Renal dosing

[thromboembolism/stroke prophylaxis]

CrCl 15-30: 75 mg bid; CrCl <15: avoid use

HD/PD: avoid use

[*VTE prophylaxis, cardioversion]

renal impairment: not defined

HD/PD: not defined

[all other indications]

CrCl >30: no adjustment; CrCl <30: not defined

HD/PD: not defined

Hepatic dosing

[not defined]

SRC: NLM .