As with many things, something new comes along and looks great. It gets approval from the great and good, and then problems appear. It was like that for the great Thalidomide scandal more than 30 years ago. Surely it is different now?
In fact, on the back of one, large, good looking study, the RE-LY study, Dabigatran was approved as a New Oral Anticoagulant (NOAC), with the advantage of simple dosing and no blood tests needed. A recent editorial in the BMJ suggests that there remain risks, and that in fact, blood levels of the drug vary more than expected. Some have suggested that blood levels be taken.
If you are on this drug, perhaps a re-evaluation is needed? It might still be the best thing for you but…the alternatives are:
1. Warfarin
2. Rivaroxiban
3. Apixaban
4. Left Atrial appendage closure- a mini-surgical procedure to reduce stroke risk.
BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4681 (Published 23 July 2014)