Dabigatran etexilate is a direct-acting oral anticoagulant used in the prevention of thromboembolism in atrial fibrillation and in the prevention and treatment of deep venous thrombosis and pulmonary embolism. Dabigatran etexilate is a pro-drug converted via plasma and hepatic esterases to dabigatran, which directly inhibits the enzyme thrombin. Thrombin catalyzes the conversion of fibrinogen to fibrin and fibrin-mediated platelet aggregation.
Dabigatran should not be prescribed in actively bleeding patients or patients with mechanical heart valves. Dabigatran toxicity may involve significant hemorrhage and is partially reversible through the reversal agent idarucizumab (Praxbind®).
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