Dabigatran
- Class: Direct thrombin inhibitor
- Used for: blood clots
- Say it: duh-BIG-uh-tran
- Forms: capsule
Factor Xa makes thrombin, and thrombin makes fibrin. The -xabans block the first step; dabigatran blocks the second. It is also the one DOAC with a specific antidote, idarucizumab.
Side effects
Common: indigestion, stomach pain, bruising
Serious: major bleeding, stomach bleeding
Typical dose
150 mg twice daily
110 mg twice daily if aged 80 or over, or at high bleeding risk. Keep in the original blister — moisture destroys it.
Check yourself
Where does dabigatran act in the clotting cascade?
- It blocks thrombin directly — the step that converts fibrinogen to fibrin
- It blocks factor Xa
- It blocks the recycling of vitamin K
- It blocks the platelet P2Y12 receptor
Show answer
A. It blocks thrombin directly — the step that converts fibrinogen to fibrin
Rivaroxaban and apixaban stop thrombin being made; dabigatran stops the thrombin that already exists from doing its job. Option three is warfarin and option four is clopidogrel — both reduce clotting by entirely different routes.
See it, don't memorize it
The app has the mechanism comic and a patient case for Dabigatran – plus the name link, the class mnemonic, pronunciation you can hear, and a self-check, for the top 100 drugs. One purchase, no subscription, no account.