1. Is dabigatran a factor Xa inhibitor?
No, dabigatran is not a factor Xa inhibitor. The active type of coagulation factor X is known as factor Xa. Rivaroxaban, apixaban, and edoxaban are all direct factor Xa (FXa) inhibitors.
Dabigatran is a direct thrombin inhibitor (factor IIa) that eliminates many of the drawbacks of warfarin.
2. Can I drink alcohol while taking dabigatran?
No. If you are using dabigatran, it is advisable to stay away from alcohol. This is because drinking too much alcohol might put you at risk for intestinal bleeding.
While using dabigatran, heavy drinking, especially consuming large amounts of alcohol in one sitting, is hazardous. Alcohol can enhance the effects of dabigatran and make you more prone to bleeding.
3. How to take dabigatran?
You should take dabigatran precisely as your doctor prescribes, for the correct dosage and duration. Do not split, chew, or crush the capsules. Do not open and pour the capsules’ contents over food or beverages. Instead, swallow them whole with sufficient water. Only if you continue to take dabigatran will it help you avoid strokes and blood clots. Even if you feel alright, keep taking dabigatran.
Tell your physician if you’re taking it before surgery, medical treatment, or a clinical procedure.
4. What is the antidote for dabigatran?
The Food and Drug Administration has authorized idarucizumab (Praxbind) to prevent or treat severe bleeding in subjects taking the anticoagulant dabigatran (Pradaxa). It is a novel direct antidote, the first of its kind, for treating life-threatening or uncontrolled bleeding caused by dabigatran usage.
5. Does dabigatran need bridging?
No, dabigatran does not need bridging. Because DOACs have short half-lives (less than 12 hours), peri-procedural administration of parenteral “bridging” anticoagulants is unnecessary.
Direct oral anticoagulants such as dabigatran, apixaban, rivaroxaban, and edoxaban do not require bridging with unfractionated or low molecular weight heparin when commencing therapy, since their effects are rapid.
6. Is dabigatran a DOAC?
Yes, dabigatran is a DOAC (Direct Oral Anticoagulants). Dabigatran, rivaroxaban, apixaban, and edoxaban are the four DOACs now accessible in the United States. DOACs are termed ‘direct’ because they cure or prevent blood clots by blocking a specific blood-clotting agent. You can take DOACs such as dabigatran orally.
7. Is dabigatran a prodrug?
Yes. Dabigatran etexilate is a prodrug advisable to take orally and fully transformed by carboxylesterases to the active form dabigatran.
However, due to its low bioavailability (7%), dabigatran is given orally as dabigatran etexilate (Pradaxa). It is a lipophilic and gastrointestinally absorbed molecule that is transformed into dabigatran via two intermediates. Serine esterases are responsible for ester bond breakage.
8. How is dabigatran metabolized?
Dabigatran is metabolized into four acyl glucuronides, each of which is a direct thrombin inhibitor that has less than 10% of the original compound's action.
Dabigatran neither metabolizes nor promotes any of the cytochrome P450 subtypes.
9. How to reverse dabigatran?
Idarucizumab is used to reverse dabigatran. It is a monoclonal antibody fragment that rapidly binds dabigatran. It has been authorized for clinical usage in required situations.
Idarucizumab is used to treat life-threatening or uncontrollable bleeding, including emergency surgeries and other urgent treatments.
10. Is dabigatran safe in pregnancy?
No, dabigatran is not advisable to be taken in pregnancy. Pregnant women should not take dabigatran as an anticoagulant, since it may induce fetal blood coagulation problems. Researchers are keenly involved in gathering information about newer anticoagulants that can substitute dabigatran in such cases.
Get a medical opinion on the uses, doses, precautions, and side effects of Dabigatran by consulting our specialists at Yashoda Hospitals.
