Avoiding adverse events with dabigatran by careful selection of eligible patients

Ross I Baker, Paul Harper and Claire McLintock
Med J Aust 2012; 196 (7): . || doi: 10.5694/mja11.11268
Published online: 16 April 2012

A new drug with great promise, but be very aware of the risks

Dabigatran is the first new oral anticoagulant for the prevention of embolism in patients with non-valvular atrial fibrillation (AF) that has been recently approved in Australia (Therapeutic Goods Administration, 1 April 2011) and New Zealand (PHARMAC, 1 July 2011), based on the results of the RE-LY (Randomized Evaluation of Long-term Anticoagulant Therapy) study.1 It is an attractive alternative to warfarin because it has a rapid onset of action (2–3 hours), a wide therapeutic range, predictable pharmacokinetics (half-life of 12–17 hours), limited drug interactions and no food interactions. Unlike warfarin, these features allow fixed doses and no requirement for routine laboratory monitoring.1

  • 1 Thrombosis and Haemophilia Sevice, Royal Perth Hospital, Perth, WA.
  • 2 Murdoch University, Perth, WA.
  • 3 Palmerston North Hospital, Palmerston, New Zealand.
  • 4 National Women's Health, Auckland City Hospital, Auckland, New Zealand.


Competing interests:

Ross Baker has undertaken clinical trials with the new anticoagulants for Boehringer Ingelheim, Bayer, Pfizer, Daiichi Sankyo, Astellas and CSL, and has served on advisory boards for Boehringer Ingelheim, Bayer and Pfizer. Paul Harper has received honoraria for educational lectures from Bayer.

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