Dabigatran (Pradaxa)

Recent media articles have focussed on the newly introduced anticoagulant Dabigatran.  There have been reports of deaths of patients using the drug and concern has been raised that the medication is very new and that it has no antidote.  All this is true.

The evidence for the safety of Dabigatran is very robust - a large trial in which over 18,000 people were randomised to receive either warfarin or dabigatran showed that the risk of bleeding on dabigatran was no higher than for warfarin and that the risk of stroke was lower.

In New Zealand, we are often among the last in the developed world to be offered new drugs.  This is for many reasons, including funding, safety concerns and the fact that we are a relatively small market.  This time, Pharmac has been convinced that dabigatran is worth funding.  This is not due to the cost of blood tests - dabigatran is much more expensive than warfarin and blood tests.  Any savings will come from the expected reduction in strokes, which is the whole point of taking the medication.

The antidote question is most often misunderstood.  Though warfarin may be reversed following overdosage by using vitamin K, this is not quick and often takes 48 hours or more to work.  Dabigatran wears off a lot faster than warfarin and simply stopping the drug should be as effective as giving vitamin K (in theory - there is little experience) Whichever drug you are taking, if you are bleeding then fresh frozen plasma is an effective means of replenishing lost clotting factors.

At Sumner Health Centre we monitor the use of many dangerous medications all the time and are confident that we have excellent systems in place to ensure your safety, whichever medication you choose.