Innehållsförteckning
Varför ges dabigatran som prodrug?
Pradaxa® (dabigatran etexilate) är en prodrug med cirka 6 % biotillgänglighet efter oral administrering. Den hydrolyseras i levern till den aktiva substansen dabigatran vilken till största delen (80‐85 %) utsöndras via njurarna. patienter med påverkad leverfunktion t. ex transaminaser > 2 gånger referensvärdet.
Är Pradaxa Eliquis Xarelto och Lixiana är blodförtunnande läkemedel som används för att förebygga blodproppar?
Warfarin orion, Pradaxa, Xarelto, Eliquis och Lixiana är läkemedel inom gruppen antikoagulantia som används för att behandla och förebygga blodproppar. Medicineringen med Waran kräver individuellt anpassad dos, därför måste man regelbundet lämna blodprov för att kontrollera INR-värdet.
Har Pradaxa lika stor blödningsrisk som Waran?
Pradaxa, med den aktiva substansen dabigatran, är nytt och har ett annat verkningssätt än Waran/Warfarin. I studierna visar det lika goda förebyggande egenskaper som Waran/Warfarin. Men tyvärr ger det även en ökad blödningsrisk jämförbar med Waran/Warfarin.
Vilka är Noak?
Fyra direktverkande Non-vitamin K Orala Antikoagulantia (NOAK) – trombinhämmaren dabigatran (Pradaxa) samt faktor Xa (FXa)-hämmarna rivaroxaban (Xarelto), apixaban (Eliquis) och edoxaban (Lixiana) – finns nu tillgängliga för prevention av stroke vid icke-valvulärt förmaksflimmer (FF).
Can INR be used to monitor dabigatran exposure?
INR is relatively insensitive to the exposure to dabigatran and cannot be interpreted the same way as used for warfarin monitoring 1 When assessment is necessary, use aPTT and not INR to assess for anticoagulant activity in patients on PRADAXA 1 PRADAXA prolongs aPTT at therapeutic doses 1
Do P-gp inhibitors increase exposure to dabigatran in renal function?
P-gp inhibition and impaired renal function are major independent factors in increased exposure to dabigatran. Concomitant use of P-gp inhibitors in patients with renal impairment is expected to increase exposure of dabigatran compared to either factor alone. Reduction of Risk of Stroke/Systemic Embolism in NVAF in Adult Patients.
What is the aPTT test for dabigatran?
aPTT is an effective qualitative method widely available for determining the presence or absence of an anticoagulant effect in patients receiving dabigatran, but cannot be used to determine the drug level. In the RE-LY trial, median trough aPTT in patients receiving a 150 mg dose of dabigatran was 52 (IQR 40-76) seconds [14].
What is dabigatran etexilate (Boehringer Ingelheim Pharmaceuticals)?
Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc. 2. van Ryn J, Stangier J, Haertter S, et al. Dabigatran etexilate—a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost. 2010;103 (6):1116-1127.
What is Pradaxa used to treat?
treating deep vein thrombosis (DVT, a blood clot in a deep vein, usually in the leg) and pulmonary embolism (PE, a clot in a blood vessel supplying the lungs) in adults, and preventing these conditions from occurring again. Pradaxa contains the active substance dabigatran etexilate. How is Pradaxa used?
What are the side effects of Pradaxa?
PRADAXA increases the risk of bleeding and can cause significant and, sometimes, fatal bleeding. Promptly evaluate any signs or symptoms of blood loss (e.g., a drop in hemoglobin and/or hematocrit or hypotension). Discontinue PRADAXA Capsules in patients with active pathological bleeding.
What should I do if Pradaxa is discontinued?
If PRADAXA is discontinued for a reason other than pathological bleeding, consider coverage with another anticoagulant and restart PRADAXA as soon as medically appropriate The degree of anticoagulant activity can also be assessed by the ECT. This test is a more specific measure of the effect of dabigatran than aPTT 1
Is Pradaxa more effective than 150 mg?
Three patients in the Pradaxa group died (less than 1%), but two of these deaths were unrelated to blood clots. In both studies, there was some evidence that a 220 mg dose of Pradaxa may be more effective than a 150 mg dose.