Medication Safety Issues
Dabigatran may be confused with vigabatrin
Pradaxa may be confused with Plavix
The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drug classes (direct oral anticoagulants; direct thrombin inhibitor) which have a heightened risk of causing significant patient harm when used in error (High-Alert Medications in Acute Care, Community/Ambulatory Care, and Long-Term Care Settings).
The Joint Commission (TJC) requires healthcare organizations that provide anticoagulant therapy to have approved protocols and evidence-based practice guidelines in place to reduce the risk of anticoagulant-associated patient harm. Patients receiving anticoagulants should receive individualized care through a defined process that includes medication selection, dosing (including adjustments for age, renal function, or liver function), drug-drug interactions, drug-food interactions, other applicable risk factors, monitoring, patient and family education, proper administration, reversal of anticoagulation, management of bleeding events, and perioperative management. This does not apply to routine short-term use of anticoagulants for prevention of venous thromboembolism during procedures or hospitalizations (NPSG.03.05.01).
Beers Criteria: Dabigatran is identified in the Beers Criteria as a potentially inappropriate medication to be used with caution over other DOAC treatment options (eg apixaban) for long-term treatment of VTE or atrial fibrillation due to an increased risk of GI bleeding compared to warfarin in head-to-head trials and an increased risk of GI bleeding and major bleeding compared to apixaban in meta-analyses and observational studies when used for long-term treatment of VTE or nonvavular atrial fibrillation (Beers Criteria [AGS 2023]).
