## Dosage and administration

### Nonvalvular atrial fibrillation

CrCl | Dose
--- | ---
>30 mL/min | 150 mg PO BID
≥15 to <30 mL/min | 75 mg PO BID
<15 mL/min or dialysis | Not recommended

### DVT and PE

CrCl | Dose
--- | ---
>30 mL/min | 150 mg PO BID
≤30 mL/min or dialysis | Not recommended

Start after 5-10 days of parenteral anticoagulation.

### Reduction in risk of recurrence of DVT and PE in patients who have been previously treated

CrCl | Dose
--- | ---
>30 mL/min | 150 mg PO BID
≤30 mL/min or dialysis | Not recommended

### Dosing modifications (atrial fibrillation)

- CrCl 30-50 mL/min and coadministration of P-gp inhibitors dronedarone or ketoconazole: Consider reducing dose to 75 mg BID. Dose adjustment not necessary when coadministered with other P-gp inhibitors
- CrCl <30 mL/min with concomitant use of P-gp inhibitors: Avoid coadministration.

### Dosing modifications (DVT/PE)

- CrCl <50 mL/min with concomitant use of P-gp inhibitors: Avoid coadministration.

## Dosage forms and strengths

- Capsules
  - 75 mg
  - 150 mg

## Contraindications

- Active pathological bleeding
- History of serious hypersensitivity reaction to dabigatran
- Mechanical prosthetic heart valve

## Warnings and precautions

- Bleeding: Can cause serious and fatal bleeding.
- Bioprosthetic heart valves: Use is not recommended.

## Adverse reactions

- Most common adverse reactions (>15%) are gastritis-like symptoms and bleeding.

## Drug interactions

- P-gp inducers rifampin: Avoid coadministration with dabigatran.
- P-gp inhibitors in patients with CrCl 30-50 mL/min: Consider reducing dose or avoid.
- P-gp inhibitors in patients with CrCl <30 mL/min: Not recommended.

## Use in specific populations

- Geriatric use: Risk of bleeding increases with age.