Pradaxa (chemical name dabigatran) is an anticoagulant medication used to prevent formation of clots that may potentially lead to strokes and embolisms. Pradaxa works by inhibiting factors that lead to potential clot formations. Pradaxa is currently most commonly used to prevent strokes and other potential clots in patients diagnosed with Atrial Fibrillation. Pradaxa is available in strengths of 75mg, 110mg, and 150mg.

What is Atrial Fibrillation?

Atrial Fibrillation is a cardiac arrhythmia (abnormal heart rhythm) that involves the upper 2 chambers (atria) of the heart. Its names comes from the chambers of the heart fibrillating (quivering). Atrial fibrillation results in abnormal electrical impulses being conducted by the heart. Atrial fibrillation often presents no symptoms and is not in itself generally life-threatening, but it may result in palpitations, fainting, chest pain, congestive heart failure, and the development of clots.

Pradaxa vs. Warfarin? Advantages and Disadvantages

For more than 50 years now, patients have had no other anticoagulant(blood thinner) alternative beyond Warfarin to prevent clots. Pradaxa now presents an important alternative. The main advantage with Pradaxa is that is does not require monitoring of INR (INR is a measurement of the blood coagulation, i.e blood clotting).

Patients when starting of Warfarin will have to be stabilized at a particular blood clotting level, and afterwards, they will have to be monitored regularly to ensure this level is maintained. The other main advantage of Pradaxa is that it has much fewer drug and even food interactions than Warfarin. Warfarin when carelessly combined with certain medications or foods may yield dangerous and at times potentially life-threatening drug interactions. The main disadvantage with Pradaxa will be the cost, Pradaxa may be as much as 5 times more costly than Warfarin. In terms of side-effects, it appears that Pradaxa has a very slight increase of GI (gastrointestinal) side effects (stomach pain, nausea, vomiting, and diarrhea), however, this is only a very minor increase. The main side effect of major bleeding appears equal between both drugs (with the dose of Pradaxa being 150mg twice daily) with the only exception being that Pradaxa has slightly less chance of major intracranial(inside the head) bleeding..

Pradaxa vs. Warfarin? Is one drug more effective in reducing clots/strokes?

It has been shown in some studies that Pradaxa is slightly more effective than Warfarin in efficacy (ie. Slightly fewer incidences of strokes and emboli as well as overall mortality with Pradaxa). NOTE, this was observed with the higher dose of Pradaxa (150mg twice daily) only. HOWEVER, as with any newer drug, the physician must take into consideration both the cost as well as the development of potential unknown future side effects before prescribing Pradaxa.

What are the potential side effects of Pradaxa?

The most common side effects of Pradaxa involve the stomach. The following side effects may occur in up to 35% of patients.

-heartburn, indigestion

-ulcers of the GI tract

-abdominal pain or discomfort

-gastroesophageal reflux disease (GERD)

Beyond these side effects, the other most common side effect will be bleeding.

Important Counseling Points
Pradaxa should not be used in patients with severe kidney or liver disease. Patients should monitor for signs of bleeding (nose bleeds, unexplained bruising, coffee ground stools, etc…) and report immediately to their primary care physician. There exists drug interactions with Pradaxa, discuss actively any new medication with your primary care physician and/or pharmacist.

This entry was posted on Tuesday, June 21st, 2011 at 8:23 am and is filed under Blood Thinners List, Coumadin, Heart Attack and Stroke, Pradaxa. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.