NICE recommends dabigatran as an option in thromboembolism

NICE has recommended that dabigatran etexilate (Pradaxa) should be considered as a possible treatment for adults with deep vein thrombosis (DVT) or pulmonary embolism (PE).

Dabigatran etexilate is rapidly absorbed and converted to its active form dabigatran, which inhibits both free and clot-bound thrombin
Dabigatran etexilate can be prescribed on the NHS for the treatment or for prevention of recurrent DVT and PE in adults.

The recommended dose of Boehringer Ingelheim's direct thrombin inhibitor in this indication is 150mg twice daily following treatment with a parenteral anticoagulant for at least five days. Treatment should be continued for at least three months based on transient risk factors (eg, recent surgery) or for longer in case of permanent risk factors or idiopathic DVT or PE.

The appraisal committee concluded that people welcome the choice of new oral anticoagulants such as dabigatran etexilate and rivaroxaban (Xarelto) because they avoid the need for the monitoring and dose adjustments associated with warfarin.

Pradaxa is also licensed for the primary prevention of venous thromboembolic events in adults who have undergone elective total hip or knee replacement surgery and for the prevention of stroke and systemic embolism in adults with non-valvular atrial fibrillation with one or more risk factors (eg, prior stroke or TIA, age ≥75 years, heart failure, diabetes or hypertension).

NICE has already published guidance approving the use of dabigatran etexilate in these indications - see TA157 (hip or knee replacement surgery) and TA249 (atrial fibrillation).

NICE guidance on dabigatran etexilate for the treatment and secondary prevention of DVT and/or PE

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