Direct Thrombin Inhibitors

Direct thrombin inhibitors prevent cleavage of fibrinogen to fibrin, and are therefore very effective anticoagulants.

Property Dabigatran
Class NOAC
Uses VTE prophylaxis, AF
Presentation 75/110mg Capsules
Route of Administration PO
Dosing VTE: 220mg daily, AF: 150mg BD
Absorption 6.5% bioavailability
Distribution 35% protein bound
Metabolism Prodrug - activated by plasma and hepatic esterases
Elimination Renal elimination of active drug
Haeme Haemorrhage
Immune Allergy
Other Significant interactions with amiodarone, quinidine, St. John's Wort, as well as other anticoagulant and antiplatelet agents. Dialysable. Potentially reversible with idarucizumab.


  1. Smith S, Scarth E, Sasada M. Drugs in Anaesthesia and Intensive Care. 4th Ed. Oxford University Press. 2011.
  2. Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.
Last updated 2019-07-18

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