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
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