Revista Española de Cardiología Revista Española de Cardiología
Rev Esp Cardiol Supl. 2012;12(B):18-24 - Vol. 12 Núm.Supl.B DOI: 10.1016/S1131-3587(12)70047-X

Farmacología de dabigatrán y su manejo clínico

Juan Fernández-Armentaa, Josep Brugadaa,

a Instituto del Tórax, Hospital Clínic, Barcelona, España

Palabras clave

Dabigatrán etexilato. Anticoagulantes. Inhibidores de la trombina. Farmacología clínica. Fibrilación auricular.

Resumen

El dabigatrán etexilato es un anticoagulante oral eficaz en la prevención de embolias en pacientes con fibrilación auricular no valvular. Es un profármaco que se transforma rápidamente en dabigatrán, un inhibidor potente, directo y reversible de la trombina. Tras su administración alcanza el pico plasmático a las 2h y tiene una vida media de 14h. Su actividad anticoagulante es predecible y no precisa monitorización de los tiempos de coagulación. El fármaco se elimina fundamentalmente por los riñones, mayormente sin alteraciones. La insuficiencia renal favorece su acumulación. El dabigatrán no se metaboliza por las isoenzimas del citocromo P450 y presenta escasas interacciones farmacológicas. Debe considerarse ajustar la dosis de dabigatrán en pacientes con edad avanzada, bajo peso corporal, alto riesgo hemorrágico o en tratamiento concomitante con verapamilo o antiagregantes plaquetarios.

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