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When is Pradaxa Preferred over Warfarin?

Here is a question from Farah Quresh in follow-up to a presentation on antithrombotics that George made May 24 during “Bioconference Live“:
What are the conditions in which Pradaxa is preferred over warfarin? Thank you.

Hello, and thank you for your question. This is a clinical judgment call that a physician may use based on economics, ability of the patient to comply, and laboratory availability. Of course, in the USA, Pradaxa (dabigatran) is cleared only for prevention of stroke in atrial fibrillation. From hearsay, it seems that most physicians retain their patients on warfarin if they are using home-testing or have ready laboratory access and are having no trouble remaining within the therapeutic INR of 2–3. If they are encountering difficulty staying in range, Pradaxa may be the answer. Also, physicians appear to be starting all their new afib patients on Pradaxa. I’ve heard from a few who are using Pradaxa off-label, would be interested in knowing more.

Here is a follow-up note: I saw your reply to my question about Pradaxa today. Thanks so much. I forwarded this information to our Pharmacists.

Marianne Thawley, MS, MT(ASCP), CLS
POC Coordinator
Western Medical Center, Santa, ANA, CA

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