Dabigatran 75 mg Capsules can be used in adults and children aged 8 years or older who are able to swallow the capsules whole. Dabigatran coated granules are available for the treatment of children below 12 years as soon as they are able to swallow soft food.
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Take dabigatran as recommended for the following conditions:
Prevention of blood clot formation after knee or hip replacement surgery
The recommended dose is 220 mg once a day (taken as 2 capsules of 110 mg).If your kidney function is decreased by more than half or if you are 75 years of age or older, the recommended dose is 150 mg once a day (taken as 2 capsules of 75 mg).
If you are taking amiodarone, quinidine or verapamil containing medicines the recommended dose is 150 mg once a day (taken as 2 capsules of 75 mg).
If you are taking verapamil containing medicines and your kidney function is decreased by more than half, you should be treated with a reduced dose of 75 mg dabigatran because your bleeding risk may be increased.
For both surgery types, treatment should not be started if there is bleeding from the site of operation. If the treatment cannot be started until the day after surgery, dosing should be started with 2 capsules once a day.
After knee replacement surgery
You should start treatment with dabigatran within 1-4 hours after surgery finishes, taking a single capsule. Thereafter two capsules once a day should be taken for a total of 10 days.
After hip replacement surgery
You should start treatment with dabigatran within 1-4 hours after surgery finishes, taking a single capsule. Thereafter two capsules once a day should be taken for a total of 28-35 days.
Treatment of blood clots and prevention of blood clots from reoccurring in children
Dabigatran should be taken twice daily, one dose in the morning and one dose in the evening, at approximately the same time every day. The dosing interval should be as close to 12 hours as possible.
The recommended dose depends on weight and age. Your doctor will determine the correct dose. Your doctor may adjust the dose as treatment progresses. Keep using all other medicines, unless your doctor tells you to stop using any.
Table 1 shows single and total daily dabigatran doses in milligrams (mg). The doses depend on weight in kilograms (kg) and age in years of the patient.
Table 1: Dosing table for dabigatran capsules
Weight in kg 11 to < 13 / Age in years 8 to < 9
Single dose 75mg / Total daily dose 150mg
Weight in kg 13 to < 16 / Age in years 8 to < 11
Single dose 110mg / Total daily dose 220mg
Weight in kg 16 to < 21 / Age in years 8 to < 14
Single dose 110mg / Total daily dose 220mg
Weight in kg 21 to < 26 / Age in years 8 to < 16
Single dose 150mg / Total daily dose 300mg
Weight in kg 26 to < 31 / Age in years 8 to < 18
Single dose 150mg / Total daily dose 300mg
Weight in kg 31 to < 41 / Age in years 8 to < 18
Single dose 185mg / Total daily dose 370mg
Weight in kg 41 to < 51 / Age in years 8 to < 18
Single dose 220mg / Total daily dose 440mg
Weight in kg 51 to < 61 / Age in years 8 to < 18
Single dose 260mg / Total daily dose 520mg
Weight in kg 61 to < 71 / Age in years 8 to< 18
Single dose 300mg / Total daily dose 600mg
Weight in kg 71 to < 81 / Age in years 8 to < 18
Single dose 300mg / Total daily dose 600mg
Weight in kg > 81 / Age in years 10 to < 18
Single dose 300mg / Total daily dose 600mg
Single doses requiring combinations of more than one capsule:
300 mg: two 150 mg capsules or
four 75 mg capsules
260 mg: one 110 mg plus one 150 mg capsule or
one 110 mg plus two 75 mg capsules
220 mg: two 110 mg capsules
185 mg: one 75 mg plus one 110 mg capsule
150 mg: one 150 mg capsule or
two 75 mg capsules
Dabigatran can be taken with or without food. The capsule should be swallowed whole with a glass of water, to ensure delivery to the stomach. Do not break, chew, or empty the pellets from the capsule since this may increase the risk of bleeding.
Without specific guidance from your doctor do not change your anticoagulant treatment.
Taking too much of this medicine increases the risk of bleeding. Contact your doctor immediately if you have taken too many capsules. Specific treatment options are available.
Prevention of blood clot formation after knee or hip replacement surgery
Continue with your remaining daily doses of dabigatran at the same time of the next day. Do not take a double dose to make up for a forgotten dose.
Treatment of blood clots and prevention of blood clots from reoccurring in children
A forgotten dose can still be taken up to 6 hours prior to the next due dose.
A missed dose should be omitted if the remaining time is below 6 hours prior to the next due dose. Do not double a dose to make up for a forgotten dose.
Take dabigatran exactly as prescribed. Do not stop taking this medicine without talking to your doctor first, because the risk of developing a blood clot could be higher if you stop treatment too early.
Contact your doctor if you experience indigestion after taking dabigatran.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Dabigatran affects blood clotting, so most side effects are related to signs such as bruising or bleeding.
Major or severe bleeding may occur, these constitute the most serious side effects and, regardless of location, may become disabling, life-threatening or even lead to death. In some cases these bleedings may not be obvious.
If you experience any bleeding event that does not stop by itself or if you experience signs of excessive bleeding (exceptional weakness, tiredness, paleness, dizziness, headache or unexplained swelling) consult your doctor immediately. Your doctor may decide to keep you under closer observation or change your medicine.
Tell your doctor immediately, if you experience a serious allergic reaction which causes difficulty in breathing or dizziness.
Possible side effects are listed below, grouped by how likely they are to happen.
Prevention of blood clot formation after knee or hip replacement surgery
Common (may affect up to 1 in 10 people):
- A fall in the amount of haemoglobin in the blood (the substance in the red blood cells).
- Unusual laboratory test results on liver function.
Uncommon (may affect up to 1 in 100 people):
- Bleeding may happen from the nose, into the stomach or bowel, from penis/vagina or urinary tract (incl. blood in the urine that stains the urine pink or red), from piles, from the rectum, under the skin, into a joint, from or after an injury or after an operation.
- Haematoma formation or bruising occurring after an operation.
- Blood detected in the stools by a laboratory test.
- A fall in the number of red cells in the blood.
- A decrease in the proportion of blood cells.
- Allergic reaction.
- Vomiting.
- Frequent loose or liquid bowel movements.
- Feeling sick.
- Wound secretion (liquid exuding from the surgical wound).
- Liver enzymes increased.
- Yellowing of the skin or whites of the eyes, caused by liver or blood problems.
Rare (may affect up to 1 in 1,000 people):
- Bleeding.
- Bleeding may happen in the brain, from a surgical incision, from the site of entry of an injection or from the site of entry of a catheter into a vein.
- Blood-stained discharge from the site of entry of a catheter into a vein.
- Coughing of blood or blood stained sputum.
- A fall in the number of platelets in the blood.
- A fall in the number of red cells in the blood after an operation.
- Serious allergic reaction which causes difficulty in breathing or dizziness.
- Serious allergic reaction which causes swelling of the face or throat.
- Skin rash notable for dark red, raised, itchy bumps caused by an allergic reaction.
- Sudden change of the skin which affects its colour and appearance.
- Itching.
- Ulcer in the stomach or bowel (incl. ulcer in the gullet).
- Inflammation of the gullet and stomach.
- Reflux of gastric juice into the gullet.
- Belly ache or stomach ache.
- Indigestion.
- Difficulty in swallowing.
- Fluid exiting a wound.
- Fluid exiting a wound after an operation.
Not known (frequency cannot be estimated from the available data):
- Difficulty in breathing or wheezing.
- Decreases in the number or even lack of white blood cells (which help to fight infections)
- Hair loss.
Treatment of blood clots and prevention of blood clots from reoccurring in children
Common (may affect up to 1 in 10 people):
- A fall in the number of red cells in the blood.
- A fall in the number of platelets in the blood.
- Skin rash notable for dark red, raised, itchy bumps caused by an allergic reaction.
- Sudden change of the skin which affects its colour and appearance.
- Haematoma formation.
- Nosebleed.
- Reflux of gastric juice into the gullet.
- Vomiting.
- Feeling sick.
- Frequent loose or liquid bowel movements.
- Indigestion.
- Hair loss.
- Liver enzymes increased.
Uncommon (may affect up to 1 in 100 people):
- Decrease in the number of white blood cells (which help to fight infections).
- Bleeding may happen into the stomach or bowel, from the brain, from the rectum, from penis/vagina or urinary tract (incl. blood in the urine that stains the urine pink or red), or under the skin.
- A fall in the amount of haemoglobin in the blood (the substance in the red blood cells).
- A decrease in the proportion of blood cells.
- Itching.
- Coughing of blood or blood stained sputum.
- Belly ache or stomach ache.
- Inflammation of the gullet and stomach.
- Allergic reaction.
- Difficulty in swallowing.
- Yellowing of the skin or whites of the eyes, caused by liver or blood problems.
Not known (frequency cannot be estimated from the available data):
- Lack of white blood cells (which help to fight infections).
- Serious allergic reaction which causes difficulty in breathing or dizziness.
- Serious allergic reaction which causes swelling of the face or throat.
- Difficulty in breathing or wheezing.
- Bleeding.
- Bleeding may happen into a joint or from an injury, from a surgical incision, or from the site of entry of an injection or from the site of entry of a catheter into a vein.
- Bleeding may happen from piles.
- Ulcer in the stomach or bowel (incl. ulcer in the gullet).
- Unusual laboratory test results on liver function.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.