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Dabigatran (Pradaxa)

Anticoagulantprescriptionoral · inferred

Prodrug of a direct thrombin inhibitor; dabigatran etexilate converts to dabigatran (active form) via sequential carboxylesterase hydrolysis. Dabigatran directly and reversibly inhibits thrombin. Rapidly absorbed in stomach/small intestine (tmax 1-2h); very low oral bioavailability (6.5%) due to ester metabolism and low membrane permeability; compensated by high dosing (110-150 mg BID). Primarily renally eliminated (>80% unchanged); use with caution in renal impairment. Half-life 14-17h. Fixed dosing. May cause more dyspepsia than other DOACs. Reversal agent (idarucizumab) available. Higher risk of GI bleeding compared to apixaban/rivaroxaban.

Projected serum levels — 150 mg, once daily

Dabigatran (Pradaxa) (precursor)
Dabigatran (Pradaxa) modeled serum levels, 150 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 5 10 15 20 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1
Dabigatran (Pradaxa) modeled serum levels with a loading dose of 215 mg, then 150 mg once daily The first dose is larger so levels approach steady state faster. 0 5 10 15 20 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 150 mg once daily (oral).

Loading schedule: 215 mg on day 1, then 150 mg once daily — reaching therapeutic levels sooner.

Modeled steady state after ~1 days: peak ≈ 13.0 mg, trough ≈ 4.3 mg body load. Population-based estimate over 15 days for a 150 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Anticoagulant
Route modeled
Oral
Model confidence
inferred
Half-life
14 h
Common dose
150 mg
Suggested maximum
150 mg/day
Reference dose range
75–150 mg (single dose)
Suggested cadence
once daily
Validated against
150 mg oral — Cmax 0.17 mg/L at 1.5 h

Documented interactions

  • warning
    St. John's Wort (Hypericum perforatum) + Dabigatran (Pradaxa) Depletion

    CYP3A4 induction reduces DOAC levels, compromising anticoagulation.

  • caution
    Prednisone + Dabigatran (Pradaxa) Depletion

    Prednisone may induce dabigatran metabolism.

  • moderate
    Carvedilol (Coreg) + Dabigatran (Pradaxa) Transporter inhibition

    Carvedilol (Coreg) inhibitor of P-gp may alter Dabigatran (Pradaxa) absorption / distribution

  • moderate
    CBD (Cannabidiol) + Dabigatran (Pradaxa) Transporter inhibition

    CBD (Cannabidiol) inhibitor of P-gp may alter Dabigatran (Pradaxa) absorption / distribution

  • moderate
    Efavirenz (Sustiva) + Dabigatran (Pradaxa) Transporter induction

    Efavirenz (Sustiva) inducer of P-gp may alter Dabigatran (Pradaxa) absorption / distribution

  • moderate
    Fisetin + Dabigatran (Pradaxa) Transporter inhibition

    Fisetin inhibitor of P-gp may alter Dabigatran (Pradaxa) absorption / distribution

Serum checks 19 modeled interaction pairings for dabigatran (pradaxa) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Clinical Pharmacokinetics and Pharmacodynamics of the Oral Direct Thrombin Inhibitor Dabigatran Etexilate Stangier J · Clinical Pharmacokinetics, 2008 DOI

    Comprehensive PK/PD review of dabigatran etexilate prodrug, carboxylesterase hydrolysis to active dabigatran, bioavailability 6.5%, renal elimination >80%, and thrombin inhibition kinetics.

  2. Carboxylesterase-2 plays a critical role in dabigatran etexilate active metabolite formation Rendic S et al. · Xenobiotica, 2023 DOI

    Molecular study showing carboxylesterase-2 (intestinal) and carboxylesterase-1 (hepatic) sequentially convert prodrug dabigatran etexilate to active dabigatran via ester hydrolysis.

  3. The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects Stangier J et al. · British Journal of Clinical Pharmacology, 2007 DOI

    Phase I study establishing dabigatran etexilate dosing, PK profile, rapid thrombin inhibition, dose proportionality, and tolerability in healthy volunteers.

3 published studies referenced in the app, each with a plain-language summary.