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摘要
BackgroundPlasma concentrations of the anticoagulant dabigatran are correlated with clinical outcomes, and are affected by renal function, intestinal P-glycoprotein (P-gp) activity and stomach acidity. %26lt;br%26gt;AimsTo determine the adherence to dabigatran etexilate renal dosing guidelines, the frequency of co-prescription of potentially interacting drugs in patients on dabigatran, and how these related to dabigatran dosing. %26lt;br%26gt;MethodsA retrospective chart review of 204 patients discharged from a tertiary hospital on dabigatran etexilate over a 12-month period. Creatinine clearance, using the Cockcroft-Gault equation, was used as the surrogate of renal function in the 86 patients where this was calculable. %26lt;br%26gt;ResultsPrescribed dabigatran etexilate dose rates in relation to creatinine clearance and the manufacturer%26apos;s guidelines were classified as standard%26apos;, low%26apos; and high%26apos; in 47% (40/86), 49% (42/86) and 5% (4/86) of patients respectively. Co-prescribed drugs that potentially interact with dabigatran etexilate were present in 75% (154/204) of patients and included strong P-gp inhibitors (16%, 32/204), proton-pump inhibitors (46%, 94/204) and anti-platelet drugs (47%, 95/204). Co-prescription of strong P-gp inhibitors was associated with the prescription of low%26apos; dose rates relative to renal P = 0.025). %26lt;br%26gt;ConclusionsFew patients were dosed excessively in relation to creatinine clearance. Around 50% was prescribed with low%26apos; dose rates in relation to creatinine clearance, which because of the association with co-prescription of strong P-gp inhibitors may be clinically appropriate. Most patients were co-prescribed with drugs that potentially interact with dabigatran etexilate.
- 出版日期2013-7
