Dabigatran (patient information)

# Why is this medication prescribed?
Dabigatran is used to help prevent strokes or serious blood clots in people who have atrial fibrillation (a condition in which the heart beats irregularly, increasing the chance of clots forming in the body, and possibly causing strokes) without heart valve disease. Dabigatran is in a class of anticoagulant (blood thinner) medications called direct thrombin inhibitors. It works by preventing blood clots from forming in the body.

# How should this medicine be used?
Dabigatran comes as a capsule to take by mouth. It is usually taken with or without food twice a day. Take dabigatran at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take dabigatran exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole; do not split, chew, or crush them. Do not open the capsules and sprinkle the contents on food or into drinks.
Dabigatran will help prevent strokes and blood clots only as long as you continue to take it. Continue to take dabigatran even if you feel well. Make sure to refill your prescription before you run out of medication so that you will not miss doses of dabigatran. Do not stop taking dabigatran without talking to your doctor. If you suddenly stop taking dabigatran, the risk that you will have a stroke may increase.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow?
Before taking dabigatran,
tell your doctor and pharmacist if you are allergic to dabigatran, any other medications, or any of the ingredients in dabigatran capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven), ongoing use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve), clopidogrel (Plavix), dronedarone (Multaq), heparin, ketoconazole (Nizoral), prasugrel (Effient), rifampin (Rifadin, Rimactane), and ticagrelor (Brilinta). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have had a valve in your heart replaced or if you have recently noticed any unusual bruising or bleeding. Your doctor probably will tell you not to take dabigatran.
tell your doctor if you are 75 years of age or older; if you have or have ever had a bleeding problem, bleeding or an ulcer in your stomach or intestine; or kidney disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dabigatran, call your doctor. Taking dabigatran may increase the risk that you will experience severe bleeding during labor and delivery.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking dabigatran.

# What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.

# What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if you remember the missed dose less than 6 hours before your next scheduled dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# What side effects can this medication cause?
Dabigatran may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- stomach pain
- heartburn
- nausea
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:
- unusual bruising or bleeding
- pink or brown urine
- red or black, tarry stools
- coughing up blood
- vomiting material that is bloody or looks like coffee grounds
- bleeding from the gums
- frequent nosebleeds
- heavy menstrual bleeding
- bleeding from a cut that lasts longer than normal
- joint pain or swelling
- headache
- dizziness
- weakness
- hives
- rash
- itching
- difficulty breathing or swallowing
- chest pain or tightness
- swelling of the face, throat, tongue, lips, eyes, arms, hands, feet, ankles, or lower legs
Dabigatran may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture. Throw away any medication that is outdated or no longer needed, and throw away any medication that is left in the container 4 months after you opened it. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include the following:
- unusual bruising or bleeding
- pink or brown urine
- red or black, tarry stools
- vomiting material that is bloody or looks like coffee grounds
- coughing up blood

# What other information should I know?
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Brand names
Pradaxa