If you take dabigatran to help prevent strokes or serious blood clots and have atrial fibrillation (a condition in which the heart beats erratically, increasing the risk of clots forming in the body and potentially causing strokes), you are at an increased risk of having a stroke after stopping the drug. Without first seeing your doctor, do not discontinue taking dabigatran. Dabigatran should still be used even if you are feeling OK. To avoid missing any dabigatran doses, make sure to replenish your prescription before it runs out of medicine. To assist prevent a blood clot from developing and leading to a stroke, your doctor may prescribe another anticoagulant (‘blood thinner’) if you need to stop taking dabigatran.

You run the risk of developing a blood clot in or near your spine if you receive epidural or spinal anaesthesia, or if you undergo a spinal puncture while taking a “blood thinner” like dabigatran. Inform your doctor if you have an epidural catheter still inside your body, have undergone spinal surgery, have had several epidural or puncture wounds, or if you have spinal deformities. If you are taking any of the following, let your physician and chemist know: Aspirin, anagrelide (Agrylin), ibuprofen (Advil, Motrin), indomethacin (Indocin, Tivorbex), ketoprofen, and naproxen (Aleve, Anaprox, others), cilostazol (Pletal), and clopidogrel are all examples of nonsteroidal anti-inflammatory medications (NSAIDs) (Plavix), heparin, ticagrelor (Brilinta), ticlopidine, tirofiban (Aggrastat), dipyridamole (Persantine), eptifibatide (Integrilin), warfarin, and prasugrel (Coumadin, Jantoven). Call your doctor right away if you have any of the following symptoms: back pain, a lack of control over your bowels or bladder, a loss of muscle strength, particularly in your legs and feet, or numbness or tingling.

Keep all of your appointments with your physician and the lab. To monitor your body’s reaction to dabigatran, your doctor may request specific lab tests.

If you need a prescription refill for dabigatran, your doctor or chemist will provide you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the information and ask your doctor or chemist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website.

In adults and children 3 months of age and older who have been treated with an injectable anticoagulant (‘blood thinner’), dabigatran is used to treat deep vein thrombosis (DVT; a blood clot, typically in the leg) and pulmonary embolism (PE; a blood clot in the lung). After the initial course of treatment is finished in adults and children 3 months of age and older, it is also used to lower the likelihood that a DVT or PE may occur once again. In adults who have had hip replacement surgery, dabigatran is used to help avoid DVT and PE. Those with atrial fibrillation, which causes the heart to beat irregularly and increases the risk of blood clots forming in the body and potentially causing strokes, but who do not have heart valve disease may also take dabigatran to help prevent strokes or significant blood clots. Dabigatran belongs to the group of anticoagulants known as direct thrombin inhibitors. It functions by halting the body’s production of blood clots.

Dabigatran is available as oral pellets and capsules. Dabigatran is often given twice daily when used to treat or prevent DVTs, PEs, as well as to avoid strokes and life-threatening blood clots in those with atrial fibrillation. Dabigatran is often administered 1 to 4 hours following surgery, then once daily for an additional 28 to 35 days in order to prevent a DVT or PE. You can take dabigatran pills with or without food. If the drug irritates your stomach, use dabigatran pills with meals. To ensure that your child gets the full dose of dabigatran, give the pellets before meals. Take dabigatran every day at roughly the same time. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Dabigatran should be taken as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

Do not break, chew, or crush the capsules; instead, take one complete capsule with a full glass of water. Never open the capsules and sprinkle the powder inside on your meal or beverage.

Apple juice or soft meals should be consumed with dabigatran pellets. Mixing the pellets with milk or foods containing milk products is not recommended. Sprinkle the entire package of dabigatran pellets on soft food, such as baby rice cereal (made with water), mashed carrots, mashed banana, or applesauce, to produce a dose of the medication. 30 minutes after distributing the pellets on the soft food, give the entire mixture. As an alternative, you can offer your youngster apple juice and dabigatran pellets. Give your child as much apple juice as they require to help them swallow the pellets once you spoon them into their mouth. Or, you may combine a tiny bit of apple juice with the pellets and have your youngster consume the entire concoction. If the pellets stay on the cup, add a little apple juice and give the cup to your kid. When all the pellets are gone, repeat as required. Use the dabigatran pellets and soft food or apple juice concoction immediately after mixing; do not keep.

Do not administer another dose of dabigatran pellets at this time if your kid does not consume the complete amount. At the appointed time, administer the subsequent dose.

As long as you keep taking dabigatran, it will help prevent blood clots and strokes. Dabigatran should still be used even if you are feeling OK. To avoid missing dabigatran doses, make sure to replenish your prescription before you run out of medicine. Without first seeing your doctor, do not discontinue taking dabigatran. The risk of developing a clot or having a stroke may rise if you abruptly stop using dabigatran.

Ask your doctor or chemist for more details if you believe this drug should be used for something else.

Before taking dabigatran,

• If you have any allergies, including to any of the substances in dabigatran capsules or pellets, notify your doctor and pharmacist right away. For a list of the ingredients, consult the Medication Guide or speak with your chemist.
• Inform your doctor and chemist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Mention dronedarone (Multaq), ketoconazole (Nizoral), and rifampin, if applicable (Rifadin, Rimactane, in Rifamate, in Rifater). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your doctor if you’ve lately seen any unusual bleeding or bruising, had a heart valve replaced, or both. Most likely, your doctor will advise against taking dabigatran.
• Inform your doctor if you have or have ever had kidney illness, a stomach or intestine ulcer, bleeding, or any other type of bleeding issue.
• Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you become pregnant while taking dabigatran. You run a higher chance of having serious bleeding during labour and delivery if you take dabigatran.
• If you are 75 years of age or older, discuss the advantages and disadvantages of taking dabigatran with your doctor.
• Inform the surgeon or dentist that you are taking dabigatran if you are having surgery, including dental surgery.

Keep eating normally unless your doctor instructs you otherwise.

As soon as you recall, take the missed dose. Skip the missing dose and carry on with your regular dosing plan, nevertheless, if you remember the missed dose less than 6 hours before your next scheduled dose. Never take two doses at once to make up for missing ones.

Side effects from dabigatran are possible. If any of these signs appear, let your doctor know:

• Stomach ache
• Stomach pain
• Heartburn
• Nausea

Some adverse effects may be severe. Get emergency medical care or call your doctor right away if you develop any of the following symptoms or any of those in the IMPORTANT WARNING section:

• Significant bruising or bleeding
• Brown or pink urine
• Tarry, crimson or black stools
• Spitting blood
• Vomiting bloody or coffee-ground-looking stuff
• Gums that are bleeding
• Several nosebleeds
• Severe bleeding during the period
• Bleeding that persists longer than usual after a wound
• Aching or swollen joints
• Headache
• Feeling lightheaded or faint
• Weakness
• Hives
• Rash
• Itching
• Breathing or swallowing challenges
• Stiffness or pain in the chest
• Edoema of the lower legs, arms, hands, feet, ankles, tongue, lips, or lower face

Further negative effects of dabigatran could occur. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Dabigatran capsules shouldn’t be kept in a pillbox or organiser. Keep it away from excessive heat and moisture at room temperature. One bottle of dabigatran pills should be opened at a time. Before opening a fresh container of dabigatran pills, finish the one you’ve already opened. 4 months after opening the container, discard any remaining capsules. Until you’re ready to use them, keep the individual dabigatran pellet packets sealed in the aluminium bag. The metal bag should be opened six months after the pellet packets are utilised.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

• Significant bruising or bleeding
• Brown or pink urine
• Tarry, crimson or black stools
• Vomiting bloody or coffee-ground-looking stuff
• Spitting blood

No one else should take your medication. Any queries you may have regarding prescription refills should be directed to your chemist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.