I was given Pradaxa (generic name: dabigatran etexilate) at a dose of 2x 110 mg in the morning, and Co-codamol (30 mg codeine and 500 mg paracetamol) at a dose of 2 tablets, 4 times a day.
I received my first dose of Pradaxa on the day of discharge from the hospital.
After the second dose of Pradaxa at home, I experienced uncomfortable pain in the kidney areas, nausea, and constipation.
I decided at that point to research my situation, leading to the development of my project entitled “Increased Risk of DVT after Total Hip Arthroplasty”.
I’m taking CBD oil 3x a day, 1x cayenne pepper (1 heaped tsp) dissolved in water in the morning , 2x high strength turmeric and black pepper supplement - with food, 1x apple in the morning, 2x dispersible aspirin (300mg) one in the morning and evening, 2x paracetamol (500mg) one in the morning and evening, a few cups of nettle tea during the day along with foods rich in tryptophan.
The above regime covers all my pain management needs and my recovery is rapid.
When a person is prescribed Pradaxa, an anticoagulant used to prevent blood clots, it complicates the use of certain pain relief options, particularly those containing opiates like co-codamol. Here’s how:
The combination of Pradaxa and Co-codamol can place patients in a difficult situation regarding pain management. The risks associated with opiates, particularly constipation and the potential for GI bleeding, require careful management, alternative strategies, and regular monitoring by healthcare providers.
Pradaxa (generic name: dabigatran etexilate) is an anticoagulant, often referred to as a blood thinner. It is primarily prescribed to prevent and treat conditions where blood clots form abnormally and pose a serious risk, such as in cases of deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke prevention in people with atrial fibrillation (AFib) not caused by a heart valve problem. Below is a comprehensive breakdown of Pradaxa’s mechanism, benefits, risks, and considerations.
Pradaxa belongs to a class of drugs known as direct thrombin inhibitors. It works by directly inhibiting thrombin, a key enzyme involved in blood clot formation. Thrombin converts fibrinogen into fibrin, which is essential in forming a stable blood clot. By inhibiting thrombin, Pradaxa prevents the formation of new clots and reduces the growth of existing clots.
Dabigatran etexilate is an anticoagulant, which means it helps prevent blood clots from forming but does not break down existing clots. Specifically, it’s a direct thrombin inhibitor that blocks the action of thrombin. This inhibition reduces the blood’s ability to form clots, which can be useful in preventing strokes, DVT, pulmonary embolism, and other conditions where clot formation is a concern.
To break down existing clots, medications like thrombolytics (e.g., tissue plasminogen activator or tPA) are used. These drugs work by dissolving the clot directly.
Dosage can vary depending on individual patient factors, including renal function, age, and concomitant use of certain medications.
One key consideration with blood thinners is the risk of bleeding. In cases where severe or life-threatening bleeding occurs, or if a patient requires urgent surgery, Pradaxa has a specific reversal agent called idarucizumab (Praxbind). This monoclonal antibody binds to dabigatran and neutralizes its effects within minutes, offering rapid control over bleeding risks.
Switching from warfarin to Pradaxa is often done in patients who struggle with maintaining stable INR levels or wish to avoid the regular monitoring associated with warfarin. However, it is crucial to stop warfarin and wait until the INR is below 2.0 before starting Pradaxa to avoid overlapping anticoagulant effects.
Pradaxa comes in a special blister pack to protect it from moisture, and patients are advised not to store it in pill organizers. Adherence is vital, as missed doses can quickly reduce anticoagulation levels, leaving patients at risk of clot formation.
Pradaxa was approved after large-scale clinical trials (e.g., the RE-LY trial) demonstrated its non-inferiority compared to warfarin in preventing strokes and systemic embolism in patients with NVAF. It has shown a lower risk of intracranial hemorrhage but a higher rate of gastrointestinal bleeding compared to warfarin.
Pradaxa is a modern anticoagulant offering convenience, efficacy, and a lower need for monitoring compared to traditional agents like warfarin. However, careful patient selection, monitoring for adverse effects, and awareness of drug interactions are critical to safe and effective use. While it provides robust protection against clots and stroke, it does so with a notable risk of bleeding, requiring a balanced approach in each patient’s treatment plan.