Dabigatran etexilate in clinical practice for prevention of thromboembolic events in patients with atrial fibrillation

Dabigatrane is the first new generation antiacoagulant that at a dose of 150 mg twice daily was, in the RE-LY study, more effective in cerebrovascular event and systemic embolisation prevention than well-controlled warfarin and had comparable or better safety profile than well-controlled warfarin. The 110 mg twice daily dose showed comparable efficacy and superior safety against warfarin. Crucial and unique among modern anticoagulants is its ability to significantly reduce ischemic as well as hemorrhagic CVEs at a dose of 150 mg twice daily. In addition, dabigatran significantly facilitates management of patients with atrial fibrillation as it does not require laboratory monitoring, has predictable pharmacokinetics, simple dosing regimen that does not require complicated dose adjustments, and does not interact with food. However, it is important to remember that it is an anticoagulant. Care should, therefore, be exercised when the treatment is indicated, renal function has to be known and it needs to be kept in mind that, as with any anticoagulant, the treatment may be associated with bleeding. However, when indication criteria are observed, the above listed advantages considered and careful patient monitoring put in place, the bleeding will be, compared to standard warfarin treatment, minimized. Key words: dabigatran - atrial fibrillation - tromboembolism.