Investigation shows dabigatran patients need monitoring

All patients starting dabigatran should undergo initial drug-level monitoring and dose adjustment due to a wide variation in plasma levels of the drug, an analysis in The BMJ suggests.

It shows evidence of a fivefold variation in dabigatran (Pradaxa) levels that may put some patients with atrial fibrillation at risk of serious bleeding, and leave others undertreated for stroke risk.

The journal reported that unpublished modelling data by manufacturer Boehringer Ingelheim showed there would be "substantial benefits in adjusting dose to optimise the level of anticoagulation in each patient".

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