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How can we monitor Dabigatran effects ?

Dabigatran, like argatroban, does prolong the prothrombin time (PT) and partial thromboplastin time (PTT). It also prolongs the thrombin time (TT), which means it  generates a false decrease in fibrinogen assay results, given that the fibrinogen assay is based on the TT. Dabigatran’s plasma concentration peaks about two hours after the drug is taken, and its half-life is 12 to 17 hours, so the PT, PTT, and fibrinogen assays should be made at least 24 hours after discontinuing dabigatran. Biophen’s Hemoclot Thrombin Inhibitor allows exploration of all the direct anti-thrombin inhibitors (DTI), targeted to human thrombin.

The Italian guidelines for stroke SPREAD (sponsored by Bayer health care) reported dabigatran as a safe alternative to warfarin. This is a sort of vital validation for the molecule since almost nothing can be done in stroke medicine without the  SPREAD committee approval at a national level. At a national level also the Mario Negri istitute for pharmacology gave its valuable opinion on Pradaxa.