Summary: A THROMBIN inhibitor which acts by binding and blocking thrombogenic activity and the prevention of thrombus formation. It is used to reduce the risk of stroke and systemic EMBOLISM in patients with nonvalvular atrial fibrillation.

Top Publications

  1. Hankey G, Eikelboom J. Dabigatran etexilate: a new oral thrombin inhibitor. Circulation. 2011;123:1436-50 pubmed publisher
  2. Gao J, Chu X, Wang L, Ning B, Zhao C. Effects of different anticoagulant drugs on the prevention of complications in patients after arthroplasty: A network meta-analysis. Medicine (Baltimore). 2017;96:e8059 pubmed publisher
  3. Steinberg B, Shrader P, Thomas L, Ansell J, Fonarow G, Gersh B, et al. Factors associated with non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II). Am Heart J. 2017;189:40-47 pubmed publisher
    ..25%) patients were started on warfarin and 3,501 (75%) on NOACs: of these latter, 259 (6%) were started on dabigatran, 1858 (40%) on rivaroxaban, and 1384 (30%) on apixaban...
  4. Gage B. Cost of dabigatran for atrial fibrillation. BMJ. 2011;343:d6980 pubmed publisher
  5. Wehling M, Collins R, Gil V, Hanon O, Hardt R, Hoffmeister M, et al. Appropriateness of Oral Anticoagulants for the Long-Term Treatment of Atrial Fibrillation in Older People: Results of an Evidence-Based Review and International Consensus Validation Process (OAC-FORTA 2016). Drugs Aging. 2017;34:499-507 pubmed publisher
    ..Other non-vitamin K antagonist oral anticoagulants (including low/high-intensity dabigatran and high-intensity edoxaban) and warfarin were assigned to FORTA-B (beneficial)...
  6. Birnie D, Healey J, Essebag V. Management of anticoagulation around pacemaker and defibrillator surgery. Circulation. 2014;129:2062-5 pubmed publisher
  7. Cove C, Hylek E. An updated review of target-specific oral anticoagulants used in stroke prevention in atrial fibrillation, venous thromboembolic disease, and acute coronary syndromes. J Am Heart Assoc. 2013;2:e000136 pubmed publisher
  8. Lowe M, Collins J, Yehia M, Eaddy N. Reversal of dabigatran with haemodialysis in a patient requiring decompression for cord compression from an epidural abscess. Nephrology (Carlton). 2013;18:580-2 pubmed publisher
  9. Agewall S, Cattaneo M, Collet J, Andreotti F, Lip G, Verheugt F, et al. Expert position paper on the use of proton pump inhibitors in patients with cardiovascular disease and antithrombotic therapy. Eur Heart J. 2013;34:1708-13, 1713a-1713b pubmed publisher

More Information


  1. Weitz J, Quinlan D, Eikelboom J. Periprocedural management and approach to bleeding in patients taking dabigatran. Circulation. 2012;126:2428-32 pubmed publisher
  2. Dubois E, Cohen A. Dabigatran etexilate. Br J Clin Pharmacol. 2010;70:14-5 pubmed publisher
  3. Kopec A, Abrahams S, Thornton S, Palumbo J, Mullins E, Divanovic S, et al. Thrombin promotes diet-induced obesity through fibrin-driven inflammation. J Clin Invest. 2017;127:3152-3166 pubmed publisher
    ..In contrast, treatment with dabigatran, a direct thrombin inhibitor, limited HFD-induced obesity development and suppressed progression of sequelae in ..
  4. Bundhun P, Chaudhary N, Yuan J. Bleeding events associated with a low dose (110 mg) versus a high dose (150 mg) of dabigatran in patients treated for atrial fibrillation: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2017;17:83 pubmed publisher
    The newer oral anticoagulant dabigatran is considered to be more beneficial in patients with non-valvular Atrial Fibrillation (AF) when compared to warfarin...
  5. Powell J. Are new oral anticoagulant dosing recommendations optimal for all patients?. JAMA. 2015;313:1013-4 pubmed publisher
  6. Eller T, Busse J, Dittrich M, Flieder T, Alban S, Knabbe C, et al. Dabigatran, rivaroxaban, apixaban, argatroban and fondaparinux and their effects on coagulation POC and platelet function tests. Clin Chem Lab Med. 2014;52:835-44 pubmed publisher
    ..years, several selectively acting anticoagulants, including the direct thrombin inhibitors (DTI; argatroban, dabigatran) and the factor Xa inhibitors (rivaroxaban, apixaban, fondaparinux), have been developed...
  7. Ehrenschwender M, Koessler J, Brunner K, Steigerwald U. A 77-year-old man with a prolonged activated partial thromboplastin time. Clin Chem. 2012;58:1402-5 pubmed
  8. Favaloro E, Bonar R, Butler J, Marsden K. Laboratory testing for the new oral anticoagulants: a review of current practice. Pathology. 2013;45:435-7 pubmed publisher
  9. Desai J, Granger C, Weitz J, Aisenberg J. Novel oral anticoagulants in gastroenterology practice. Gastrointest Endosc. 2013;78:227-39 pubmed publisher
  10. Kwon I, An S, Kim J, Yang S, Yoo J, Baek J, et al. Hemorrhagic Transformation After Large Cerebral Infarction in Rats Pretreated With Dabigatran or Warfarin. Stroke. 2017;48:2865-2871 pubmed publisher
    It is uncertain whether hemorrhagic transformation (HT) after large cerebral infarction is less frequent in dabigatran users than warfarin users...
  11. Harper P, Young L, Merriman E. Bleeding risk with dabigatran in the frail elderly. N Engl J Med. 2012;366:864-6 pubmed publisher
  12. Paquette M, Riou Franca L, Teutsch C, Diener H, Lu S, Dubner S, et al. Persistence With Dabigatran Therapy at 2 Years in Patients With Atrial Fibrillation. J Am Coll Cardiol. 2017;70:1573-1583 pubmed publisher
    ..The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up...
  13. Calkins H, Willems S, Gerstenfeld E, Verma A, Schilling R, Hohnloser S, et al. Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. N Engl J Med. 2017;376:1627-1636 pubmed publisher
    ..Uninterrupted anticoagulation with a non-vitamin K antagonist oral anticoagulant, such as dabigatran, may be safer; however, controlled data are lacking...
  14. Thompson C. First oral thrombin inhibitor enters market: drug does not require clinicians to monitor INR. Am J Health Syst Pharm. 2010;67:1974, 1976 pubmed publisher
  15. Trip J, Hamer P, Flint R. Intramural oesophageal haematoma-a rare complication of dabigatran. N Z Med J. 2017;130:80-82 pubmed
    ..Oesophageal haematoma along with Mallory-Weiss and Boerhaave's syndromes make up acute mucosal injury of the oesophagus. It can be managed conservatively in the majority of cases. ..
  16. Jud P, Gary T, Tiesenhausen K, Portugaller R, Hackl G, Brodmann M. Renal failure caused by a partly calcified aortic aneurysm in a patient with dabigatran therapy: A case report. Medicine (Baltimore). 2017;96:e6789 pubmed publisher
    ..However, there are also unusual complications caused by aortic aneurysms. An 87-old male with dabigatran therapy presented with newly developed melena and acute renal failure...
  17. Connolly S, Wallentin L, Yusuf S. Additional events in the RE-LY trial. N Engl J Med. 2014;371:1464-5 pubmed publisher
  18. Collings S, Lefevre C, Johnson M, Evans D, Hack G, Stynes G, et al. Oral anticoagulant persistence in patients with non-valvular atrial fibrillation: A cohort study using primary care data in Germany. PLoS ONE. 2017;12:e0185642 pubmed publisher
    ..aged ?70) with NVAF and no prior OAC therapy who were prescribed apixaban (n = 1,303), rivaroxaban (n = 5,742), dabigatran (n = 1,622) or vitamin-K antagonists (VKAs, n = 6,577) between 1-Dec-2012 and 31-Oct-2014 in German primary care ..
  19. Andreas M, Moayedifar R, Wieselthaler G, Wolzt M, Riebandt J, Haberl T, et al. Increased Thromboembolic Events With Dabigatran Compared With Vitamin K Antagonism in Left Ventricular Assist Device Patients: A Randomized Controlled Pilot Trial. Circ Heart Fail. 2017;10: pubmed publisher
    ..Patients were randomized to receive either phenprocoumon or dabigatran in addition to aspirin for long-term anticoagulation...
  20. Haynes L, Orfeo T, Mann K, Everse S, Brummel Ziedins K. Probing the Dynamics of Clot-Bound Thrombin at Venous Shear Rates. Biophys J. 2017;112:1634-1644 pubmed publisher
    ..b>Dabigatran (20 and 200 nM) inhibits (50 and 93%) clot-bound thrombin reversibly (87 and 66% recovery)...
  21. Lauffenburger J, Farley J, Gehi A, Rhoney D, Brookhart M, Fang G. Effectiveness and safety of dabigatran and warfarin in real-world US patients with non-valvular atrial fibrillation: a retrospective cohort study. J Am Heart Assoc. 2015;4: pubmed publisher
    The recent availability of dabigatran, a novel oral anticoagulant, provided a new treatment option for stroke prevention in atrial fibrillation beyond warfarin, the main therapy for years...
  22. Grottke O, van Ryn J, Spronk H, Rossaint R. Prothrombin complex concentrates and a specific antidote to dabigatran are effective ex-vivo in reversing the effects of dabigatran in an anticoagulation/liver trauma experimental model. Crit Care. 2014;18:R27 pubmed publisher
    ..complex concentrate (PCC), activated PCC (aPCC), recombinant FVIIa (rFVIIa) and a specific antidote to dabigatran (aDabi-Fab) to reverse the anticoagulant effects of dabigatran...
  23. Cohen D. Concerns over data in key dabigatran trial. BMJ. 2014;349:g4747 pubmed publisher
  24. Cohen D. Dabigatran: how the drug company withheld important analyses. BMJ. 2014;349:g4670 pubmed publisher
  25. Potpara T. Dabigatran in 'real-world' clinical practice for stroke prevention in patients with non-valvular atrial fibrillation. Thromb Haemost. 2015;114:1093-8 pubmed publisher
  26. Cannon C, Bhatt D, Oldgren J, Lip G, Ellis S, Kimura T, et al. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med. 2017;377:1513-1524 pubmed publisher
    ..clopidogrel or ticagrelor) and aspirin (for 1 to 3 months) (triple-therapy group) or dual therapy with dabigatran (110 mg or 150 mg twice daily) plus a P2Y12 inhibitor (clopidogrel or ticagrelor) and no aspirin (110-..
  27. Pollack C, Reilly P, van Ryn J, Eikelboom J, Glund S, Bernstein R, et al. Idarucizumab for Dabigatran Reversal - Full Cohort Analysis. N Engl J Med. 2017;377:431-441 pubmed publisher
    Idarucizumab, a monoclonal antibody fragment, was developed to reverse the anticoagulant effect of dabigatran. We performed a multicenter, prospective, open-label study to determine whether 5 g of intravenous idarucizumab would be able to ..
  28. Kobayashi L, Barmparas G, Bosarge P, Brown C, Bukur M, Carrick M, et al. Novel oral anticoagulants and trauma: The results of a prospective American Association for the Surgery of Trauma Multi-Institutional Trial. J Trauma Acute Care Surg. 2017;82:827-835 pubmed publisher
    ..Inclusion criteria was any trauma patient admitted on aspirin, clopidogrel, warfarin, dabigatran, rivaroxaban, or apixaban...
  29. Katsnelson M, Sacco R, Moscucci M. Progress for stroke prevention with atrial fibrillation: emergence of alternative oral anticoagulants. Circulation. 2012;125:1577-83 pubmed publisher
  30. Southworth M, Reichman M, Unger E. Dabigatran and postmarketing reports of bleeding. N Engl J Med. 2013;368:1272-4 pubmed publisher
  31. Yokoi K, Isoda K, Kimura T, Adachi T. Diffuse alveolar hemorrhage associated with dabigatran. Intern Med. 2012;51:2667-8 pubmed
  32. Eikelboom J, Weitz J. Dabigatran monitoring made simple?. Thromb Haemost. 2013;110:393-5 pubmed publisher
  33. Coleman C, Peacock W, Bunz T, Alberts M. Effectiveness and Safety of Apixaban, Dabigatran, and Rivaroxaban Versus Warfarin in Patients With Nonvalvular Atrial Fibrillation and Previous Stroke or Transient Ischemic Attack. Stroke. 2017;48:2142-2149 pubmed publisher
    ..analyses were performed comparing 1:1 propensity score-matched cohorts of apixaban versus warfarin (n=2514), dabigatran versus warfarin (n=1962), and rivaroxaban versus warfarin (n=5208)...
  34. Yao X, Shah N, Sangaralingham L, Gersh B, Noseworthy P. Non-Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction. J Am Coll Cardiol. 2017;69:2779-2790 pubmed publisher
    ..Using a large U.S. administrative database, 14,865 patients with AF were identified who initiated apixaban, dabigatran, or rivaroxaban between October 1, 2010, and September 30, 2015...
  35. Mugnai G, De Asmundis C, Iacopino S, Ströker E, Longobardi M, De Regibus V, et al. Comparison of the Incidences of Complications After Second-Generation Cryoballoon Ablation of Atrial Fibrillation Using Vitamin K Antagonists Versus Novel Oral Anticoagulants. Am J Cardiol. 2017;120:223-229 pubmed publisher
    ..1%) were treated with NOACs (rivaroxaban: n = 71; dabigatran: n = 60; and apixaban: n = 33). Age was significantly higher in the group II (62.8 ± 9.7 vs 58.6 ± 11...
  36. Gundlund A, Staerk L, Fosbøl E, Gadsbøll K, Sindet Pedersen C, Bonde A, et al. Initiation of anticoagulation in atrial fibrillation: which factors are associated with choice of anticoagulant?. J Intern Med. 2017;282:164-174 pubmed publisher
    ..pharmacotherapy and CHA2 DS2 -VASc and HAS-BLED scores in patients initiated on a VKA, dabigatran, rivaroxaban or apixaban. Differences were examined using multivariable logistic regression models...
  37. Eikelboom J, Quinlan D, van Ryn J, Weitz J. Idarucizumab: The Antidote for Reversal of Dabigatran. Circulation. 2015;132:2412-22 pubmed publisher
  38. Lillo Le Louët A, Wolf M, Soufir L, Galbois A, Dumenil A, Offenstadt G, et al. Life-threatening bleeding in four patients with an unusual excessive response to dabigatran: implications for emergency surgery and resuscitation. Thromb Haemost. 2012;108:583-5 pubmed publisher
  39. Dinkelaar J, Patiwael S, Harenberg J, Leyte A, Brinkman H. Global coagulation tests: their applicability for measuring direct factor Xa- and thrombin inhibition and reversal of anticoagulation by prothrombin complex concentrate. Clin Chem Lab Med. 2014;52:1615-23 pubmed publisher
    ..Plasma and whole blood were spiked with apixaban or dabigatran and PCC was added to these samples...
  40. Hobl E, Jilma B. Towards the development of specific antidotes: Idarucizumab for reversal of dabigatran effects. Thromb Haemost. 2015;113:1162-3 pubmed publisher
  41. Gage B. Can we rely on RE-LY?. N Engl J Med. 2009;361:1200-2 pubmed publisher
  42. Boos C, Nam M, Camm A. Novel oral anticoagulants and stroke prevention in atrial fibrillation and chronic heart failure. Heart Fail Rev. 2014;19:391-401 pubmed
    ..Three recently approved novel anticoagulants (dabigatran, rivaroxaban and apixaban) are already challenging warfarin use in AF...
  43. Sauter T, Amylidi A, Ricklin M, Lehmann B, Exadaktylos A. Direct new oral anticoagulants in the emergency department: Experience in everyday clinical practice at a Swiss university hospital. Eur J Intern Med. 2016;29:e13-5 pubmed publisher
  44. Ebner M, Birschmann I, Peter A, Härtig F, Spencer C, Kuhn J, et al. Emergency Coagulation Assessment During Treatment With Direct Oral Anticoagulants: Limitations and Solutions. Stroke. 2017;48:2457-2463 pubmed publisher
    ..lt;30 ng/mL (rivaroxaban/PT: specificity, 77%/sensitivity, 94%; apixaban/PT: specificity, 13%/sensitivity, 94%, dabigatran/aPTT: specificity, 49%/sensitivity, 91%). Normal TT was 100% specific for dabigatran, but sensitivity was 26%...
  45. Warkentin T, Margetts P, Connolly S, Lamy A, Ricci C, Eikelboom J. Recombinant factor VIIa (rFVIIa) and hemodialysis to manage massive dabigatran-associated postcardiac surgery bleeding. Blood. 2012;119:2172-4 pubmed publisher
  46. Ntaios G, Papavasileiou V, Makaritsis K, Vemmos K, Michel P, Lip G. Real-World Setting Comparison of Nonvitamin-K Antagonist Oral Anticoagulants Versus Vitamin-K Antagonists for Stroke Prevention in Atrial Fibrillation: A Systematic Review and Meta-Analysis. Stroke. 2017;48:2494-2503 pubmed publisher
    ..In 28 included studies of dabigatran, rivaroxaban, and apixaban compared with vitamin-K antagonists, all 3 nonvitamin-K oral anticoagulants were ..
  47. Wann L, Curtis A, Ellenbogen K, Estes N, Ezekowitz M, Jackman W, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2011;57:1330-7 pubmed publisher
  48. Tomoda M, Yasaka M, Nakanishi Y, Takaguchi G, Nakamura A, Gotoh S, et al. [Measurement of Prothrombin Fragment 1+2 for the Assessment of Anticoagulant Activity in Patients Treated with Warfarin or Non-vitamin K Antagonist Oral Anticoagulant]. Brain Nerve. 2017;69:571-576 pubmed publisher
    ..5, and 1 of whom developed intracerebral hemorrhage. Plasma levels of PF1+2 in patients treated with dabigatran 150mg BID, dabigatran 110mg BID, rivaroxaban 15mg QD, rivaroxaban 10mg QD, apixaban 5mg BID, apixaban 2...
  49. Schattner A, Kozak N, Friedman J. Fatality in a patient treated with dabigatran. Am J Emerg Med. 2013;31:443.e1-2 pubmed publisher
  50. Fanikos J, Burnett A, Mahan C, Dobesh P. Renal Function Considerations for Stroke Prevention in Atrial Fibrillation. Am J Med. 2017;130:1015-1023 pubmed publisher
    ..Limited data address the risk-benefit profile of DOACs in patients with severe impairment or on dialysis. ..
  51. Schulman S, Ritchie B, Goy J, Nahirniak S, Almutawa M, Ghanny S. Activated prothrombin complex concentrate for dabigatran-associated bleeding. Br J Haematol. 2014;164:308-10 pubmed publisher
  52. Reed S. How country-specific should a country-specific cost-effectiveness analysis be?. Eur Heart J. 2013;34:166-7 pubmed publisher
  53. Meltzer J, Guenzer J. Anticoagulant Reversal and Anesthetic Considerations. Anesthesiol Clin. 2017;35:191-205 pubmed publisher
    ..Recombinant activated factor VII is a nonspecific procoagulant that activates the extrinsic clotting pathway, resulting in thrombin generation, but does not directly neutralize the activity of any of the new oral anticoagulants. ..