Prophylaxis of thromboembolism in nonvalvular atrial fibrillation
- 150 mg PO bid
Converting from or to warfarin
- When converting patients from warfarin to dabigatran: Discontinue warfarin and start therapy with this drug when the international normalized ratio (INR) is less than 2.0
- When converting from dabigatran to warfarin: Adjust the starting time of warfarin based on CrCl
- >50 mL/min: Start warfarin 3 days before discontinuing dabigatran
- 31-50 mL/min: Start warfarin 2 days before discontinuing dabigatran
- 15-30 mL/min: Start warfarin 1 day before discontinuing dabigatran
- <15 mL/min: Dose adjustments not defined
Converting from or to parenteral anticoagulants
- Conversion from a parenteral anticoagulant: Start dabigatran 0-2 hrs before administration of the next dose of the parenteral drug or at the time of discontinuation of a continuously administered parenteral drug
- Conversion to a parenteral anticoagulant: Wait 12 hrs (CrCl
30 mL/min) or 24 hrs (CrCl <30 mL/min) after the last dose of dabigatran before initiating treatment with a parenteral anticoagulant
Note:
- Advise patients to swallow the capsules whole. should be taken with a full glass of water. Breaking, chewing, or emptying the contents of the capsule can result in increased exposure
- If a therapy is not taken at the scheduled time, the dose should be taken as soon as possible on the same day; the missed dose should be skipped if it cannot be taken at least 6 hours before the next scheduled dose
- Safety and effectiveness in pediatric patients has not been established
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