The Oral Thrombin Inhibitor Dabigatran: Strengths and Weaknesses

Sam Schulman; Ammar Majeed

doi:10.1055/s-0031-1300946

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2012; 38(01): 07-15
DOI: 10.1055/s-0031-1300946

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Oral Thrombin Inhibitor Dabigatran: Strengths and Weaknesses

Sam Schulman

¹Department of Medicine, McMaster University and Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada

²Department of Hematology, Karolinska University Hospital and Institute, Stockholm, Sweden

,

Ammar Majeed

²Department of Hematology, Karolinska University Hospital and Institute, Stockholm, Sweden

³Department of Medicine, Mälar Hospital, Eskilstuna, Sweden

› Author Affiliations

Abstract

Since the quest for a better replacement of warfarin started several decades ago and new compounds were brought forward to clinical trials, the concept of an ideal anticoagulant frequently became presented in lectures and articles. We have here reviewed strengths and weaknesses of the oral thrombin inhibitor dabigatran in terms of pharmacokinetics and clinical data. When strengths clearly exceed the weaknesses for any characteristic, the drug fits into the concept of an ideal anticoagulant in that domain. It is evident that dabigatran does not accomplish that concept for all characteristics but it reaches well above warfarin. We believe it is unlikely that any drug will fulfill all criteria for the ideal anticoagulant. Laboratory testing for dabigatran will not be discussed in any detail in this article, which is instead the focus of other articles from this issue of Seminars in Thrombosis & Hemostasis.

Keywords

dabigatran - warfarin - low-molecular-weight heparin - efficacy - bleeding

Full Text

References

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