Dabigatran (Pradaxa) interacts with many medicines, but it doesn’t appear to interact with foods.
Tell your doctor about all the medicines you are taking
Dabigatran can interact with many different medicines so it is very important that you tell all your health professionals about all the medicines you are taking — including prescription, over-the-counter and complementary medicines (herbal, ‘natural’, and vitamin and mineral supplements). This is because all medicines, including herbal and natural medicines, can cause side effects and may interact with dabigatran.
Keep a list of all your medicines and take it with you when you visit the doctor or pharmacist.
What are the interactions with dabigatran?Do not take dabigatran if you are taking medicines below:
- verapamil (Isoptin, Isoptin SR, Veracaps) — a calcium channel blocker used to treat high blood pressure and atrial fibrillation
- oral ketoconazole (Nizoral) — used to treat fungal infections.
Other medicines can also interact with dabigatran, but you may not need to avoid them entirely. However, the doses may need to be changed or you may need to be monitored regularly. Tell your doctor or pharmacist if you are taking:
- other anticoagulant medicines, such as warfarin (Coumadin, Marevan), enoxaparin (Clexane), dalteparin (Fragmin), clopidogrel (e.g. Plavix)
- pain relief or anti-inflammatory medicines, like aspirin (e.g. Aspro Clear, Disprin, Solprin), ibuprofen (e.g. Advil, Nurofen) and diclofenac (e.g. Fenac, Voltaren)
- medicines used to treat atrial fibrillation, like amiodarone (e.g. Cordarone)
- stomach ulcer and reflux medicines, like pantoprazole (e.g. Somac) and ranitidine (Zantac)
- antidepressant medicines, such as fluoxetine (e.g. Prozac) and paroxetine (e.g. Aropax)
- medicines for HIV infection, such as lopinavir/ritonavir (Kaletra) and saquinavir (Invirase)
- antibiotics such as clarithromycin (e.g. Klacid) and rifampicin (e.g. Rifadin)
- a vitamin, herbal or complementary remedy (e.g. St John’s wort).
This is not a full list of all the medicines that can interact with dabigatran. For more information on interactions, see the dabigatran (Pradaxa) Consumer Medicine Information (CMI), available on this website or from your pharmacist.
If you have any concerns about interactions, talk to your doctor. Do not change your dose or stop taking any of your medicines — unless advised by your doctor. They can advise you whether you need to adjust the dose of one medicine or avoid it all together.
Note about medicines names
Most medicines have two names: the active ingredient and the brand name. The active ingredient is the chemical in the medicine that makes it work. The brand name is the name given to the medicine by its manufacturer. There may be several brands that contain the same active ingredient. This website uses active ingredient names, with brand names in brackets. We also discuss medicines in groups or ‘classes’, when their effects or actions are very similar.
Who can I ask about interactions?
People with questions about their medicines or seeking general information about side effects and interactions can call the NPS Medicines Line on 1300 633 424 (Monday–Friday, 9am–5pm AEST). To report possible side effects call the Adverse Medicine Events (AME) Line on 1300 134 237 from anywhere in Australia (Monday–Friday, 9am–5pm AEST).
Find out more about:
- Rossi S, ed. eAMH [online]. Australian Medicines Handbook, January 2013. www.amh.net.au (accessed June 2013).
- Cardiovascular Expert Group. Therapeutic guidelines: cardiovascular. Therapeutic Guidelines Ltd; 2013. www.tg.org.au (accessed June 2013).
- NPS Medicine Update, April 2010. Dabigatran (Pradaxa) for preventing blood clots after hip or knee replacement surgery
- NPS Medicine Update, August 2011. Dabigatran (Pradaxa) for preventing stroke in people with atrial fibrillation