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Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke in patients with atrial fibrillation (JW Oncol Hematol Oct 6 2009). It is administered in a fixed dose (150 mg twice daily) and does not require monitoring, which are advantages over warfarin. However, recent data suggest that, compared with warfarin, dabigatran might be associated with more frequent serious adverse effects.
Now, an editorialist has reviewed reports of serious or fatal bleeding associated with dabigatran and found that, during the first 6 months of availability, the drug was responsible for 505 adverse events due to hemorrhage (including 65 deaths), compared with only 176 for warfarin. Some of these events were in patients who recei…