Key result
An 83-year-old female with atrial fibrillation developed gastrointestinal bleeding while taking dabigatran concurrently with NSAIDs and P-gp-modulating drugs in the setting of impaired renal function.
Why the study?
Does the combination of dabigatran, NSAIDs, and P-gp-modulating drugs cause gastrointestinal bleeding in an elderly patient with impaired renal function?
Case Report (n=1)
Does the combination of dabigatran, NSAIDs, and P-gp-modulating drugs cause gastrointestinal bleeding in an elderly patient with impaired renal function?
NSAIDs and P-gp-modulating drugs should be avoided in dabigatran-treated patients, and dabigatran dosage must be reduced or stopped if renal function deteriorates.
Suggests heightened bleeding risk in elderly AF patients with renal impairment on interacting drugs; hypothesis-generating and should not yet change practice.
Dabigatran-absorption is dependent on the intestinal P-glycoprotein (P-gp)-system, and P-gp activity is modulated by several drugs. We report an 83-old female with atrial fibrillation who developed gastrointestinal bleeding. She was under a therapy with non-steroidal anti-inflammatory drugs (NSAID) and P-gp-modulating drugs and renal function was impaired. We conclude that NSAID and P-gp-modulating drugs should be avoided in dabigatran-treated patients. If renal function deteriorates the dabigatran-dosage should be reduced or the therapy should be stopped. There is an urgent need to increase knowledge about drug interactions with dabigatran.
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Stöllberger et al. (2014) conducted a case report in Atrial fibrillation (n=1). Dabigatran with concurrent NSAIDs and P-gp-modulating drugs was evaluated on Gastrointestinal bleeding. An 83-year-old female with atrial fibrillation developed gastrointestinal bleeding while taking dabigatran concurrently with NSAIDs and P-gp-modulating drugs in the setting of impaired renal function.
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