Pradaxa (Dabigatran)

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Pradaxa (Dabigatran) is an oral anticoagulant, or blood thinner. It works to help prevent the formation of blood clots. It is also used to help prevent strokes in patients with irregular heartbeats. It can also be used after knee or hip replacement surgery to prevent blood clots from forming. Pradaxa works to block the activity of a protein called thrombin which in turn helps prevent the formation of blood clots.

This medication is manufactured by Boehringer Ingelheim and is available in the following dosages: Pradaxa (Dabigatran) 75mg, Pradaxa (Dabigatran) 110mg and Pradaxa (Dabigatran) 150mg.  It is available in packs of 60 capsules which are sealed in blisters.  A typical 3-month supply would be 180 capsules as Pradaxa is often taken twice daily.

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Pradaxa (Dabigatran) Medication Information

Uses

Pradaxa (dabigatran) is a blood thinner medication that reduces the chance of getting blood clots.  People with certain medical conditions have a higher risk of getting blood clots, which can be life-threatening.  

Our blood naturally stops bleeding at the site of an injury by forming clots.  But sometimes blood clots can form when they aren’t supposed to.  Clots are dangerous because they could travel to the brain and cause a stroke, among other serious problems.  The risk of getting a blood clot is highest after major surgery or injury, or when you have heart problems, cancer, or take hormone-based medications.

Pradaxa is prescribed to reduce the risk of stroke and blood clots in adults who have certain medical conditions such as atrial fibrillation (AFib).  In AFib, the heart does not beat the way it should and can lead to the formation of clots.  

Pradaxa is also prescribed to treat blood clots that have already formed in the legs or lungs.  Pradaxa works to dissolve the clots and reduce the risk of developing them again.  Pradaxa may also be prescribed to prevent blood clots after hip replacement surgery.

Dosage

Pradaxa is an oral capsule and comes in three strengths:

• 75 mg
• 110 mg
• 150 mg

Pradaxa should be taken twice a day, approximately every 12 hours.  Take it exactly as prescribed by your doctor.  

Warnings and Precautions

Pradaxa is not safe for certain individuals with the following health conditions:

• Heart valve replacements
• Bleeding problems
• Previous allergic reaction to Pradaxa
• Pregnant or plan to become pregnant or breastfeed

Some people have a higher chance of serious side effects from Pradaxa.  Let your doctor know if you have ever had:

• Bleeding problems
• Kidney problems
• Stomach ulcers

Side Effects

Like all medications, Pradaxa has potential side effects.  The most common side effects are mild, but severe side effects are also possible.  

The most common but usually mild side effects of Pradaxa include:

• Bleeding and bruising (tendency to bruise more easily or bleed longer from a minor cut)
• Heartburn
• Nausea
• Stomach pain

Serious side effects can rarely occur with Pradaxa, including:

• Allergic reaction
• Bleeding that is uncontrolled, severe, or life-threatening*
• Dangerous blood clots can occur when people who take blood thinning drugs like Pradaxa get certain types of spinal or epidural injections.  This type of blood clot can lead to permanent disability.    

Your doctor will prescribe Pradaxa if its benefits outweigh your risks for serious side effects.  For more information about Pradaxa’s side effects, talk with your doctor or pharmacist. 

*See FAQ section below for more details on the signs of bleeding to be aware of when taking Pradaxa.

Drug Interactions

Some medications could cause harm when taken with Pradaxa.  Some examples include:

• Aspirin
• Clopidogrel
• Ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS)
• Ketoconazole
• Rifampin
• Warfarin

Talk with your doctor or pharmacist before taking any other medication or supplement with Pradaxa.

Storage

Keep Pradaxa in its original bottle or package at room temperature (20°C to 25°C; 68°F to 77°F).  Close the Pradaxa bottle tightly after each dose.

Pharmacists Tips

• Pradaxa should be taken with a full glass of water and may be taken with or without food.
• Do not store Pradaxa capsules in pill organizers; keep in original bottle.
• After opening a bottle of Pradaxa, the capsules expire 4 months later.  If you receive multiple bottles of Pradaxa from your pharmacy, wait to open each bottle once you are ready to use it.

Pradaxa FAQs

What should I do if I miss a dose of Pradaxa?

If you miss a dose of Pradaxa, take it as soon as possible.  However, if your next dose is less than 6 hours away, skip the missed dose.  Do not take two doses of Pradaxa at the same time.

It is very important not to miss doses of Pradaxa.  This could increase your chance of having a stroke.  Set an alarm or keep your bottle of Pradaxa somewhere that you will see it often, like your kitchen table.

I am concerned about the risk of bleeding with Pradaxa.  How will I know if I am having this side effect?

With Pradaxa, you may notice that you bruise more easily and it might take longer to stop bleeding from a minor cut.  However, if you have any of these signs of bleeding, you should call your doctor:

• Joint pain or swelling
• Frequent nose bleeds
• Dizziness or headache
• Any bleeding that takes a long time to stop
• Menstrual or vaginal bleeding that is heavier than usual

If you experience any of these signs of severe bleeding, you should seek emergency medical care immediately:

• Bruises that get bigger or appear randomly
• Brown or pink urine
• Coughing up blood
• Red or black stool
• Vomiting blood, or vomit that looks like coffee ground

Related Drugs

• Eliquis
• Plavix
• Pletal
• Warfarin
• Xarelto

References

1. Pradaxa Prescribing Information.  Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2020. https://docs.boehringer-ingelheim.com/Prescribing%20Information/PIs/Pradaxa/Pradaxa.pdf Accessed December 1, 2020.
2. Venous Thromboembolism. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/venous-thromboembolism Accessed December 1, 2020.