It's already widely-known that Boehringer-Ingelheim's anti-coagulant drug, Pradaxa, carries a high risk of patients bleeding to death – and, to add insult to injury, costs that are fifteen times those of warfarin (Pradaxa and its new competitor, Xarelto, run $3,000 a year compared to $200 for warfarin). Doctors nonetheless like Pradaxa (dabigatran) because it's relatively trouble-free; there are few interactions with other drugs and the dosage requires far less adjustments over time than warfarin – meaning less in the way of costly patient monitoring.
On the other hand, the Institute for Safe Medication Practices reports that bleeding from Pradaxa is five times more likely to have fatal results than that caused by warfarin. Furthermore, this figure was consistent among all patients, regardless of age and gender. As if this were not bad enough, some professionals in the medical profession are now expressing concern about the possible long-term effects of Pradaxa.
The fact that there is still no antidote does not help.
An antidote for Pradaxa's competitors, Xarelto and Eliquis (like Pradaxa, these are “direct Factor-Xa inhibitors”), is in the works, thanks to the efforts of a small San Francisco-based firm, Portola Pharmaceuticals. The new antidote acts by diverting anti-coagulant medications away from Factor Xa (this is what allows blood to clot), thus allowing it to do its work. This antidote is currently undergoing clinical trials – but it won't be of much help to Pradaxa patients who have already suffered injury.
Komaroff, Anthony MD. “Ask Doctor K: Long-Term Side Effects of Pradaxa Unknown.” Scripps Howard News Service, via Eureka Times-Standard, 19 February 2013.
N/A. “Findings For Specific Drugs – Update on Anti-coagulants.” ISMP Quarter Watch, 9 January 2013.
Phend, Crystal. “Xarelto, Eliquis Antidote In the Works.” MedPage Today, 6 February 2013.
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