Pradaxa, an anticoagulant medication, is used in managing stroke and blood clots in patients with heart conditions like atrial fibrillation and prevention of vein thrombosis, as well as pulmonary embolism.

It is prescribed to children from 3 months of age to 18 years and adults, to prevent the recurrent blood clot.

Pradaxa works by inhibiting the action of thrombin in the blood clotting process. Thrombin is responsible for converting fibrinogen into fibrin which forms blood clots.

By blocking thrombin from activating the coagulation factors, Pradaxa prevents the formation of a blood clot in your body. It also prevents existing clots from growing larger and reduces the risk of stroke and other heart conditions.

Precautions and Warnings with Pradaxa

  • Bleeding Complications: Using Pradaxa raises the chances of bleeding complications, which can be severe and occasionally life-threatening. You should seek medical attention in case you notice any symptoms of blood loss.
  • Spinal or Epidural Hematomas: Patients suffering from spinal puncture and are taking spinal anaesthesia while using Pradaxa face a high risk of developing Spinal or Epidural Hematomas, which may lead to long-term paralysis.
  • Bleeding and Thromboembolic Events: Taking Pradaxa increases the chances of developing bleeding complications, including nosebleeds and thromboembolic events such as strokes and myocardial infections.
  • Allergic Reactions: Before taking Pradaxa, inform your doctor if you have any allergic reactions to Pradaxa because it may cause adverse side effects.
  • Antiphospholipid Syndrome: If you are suffering from triple-positive antiphospholipid syndrome, you may be at high risk of having blood clots when using Pradaxa.
  • Surgery: It is advisable that you stop taking Pradaxa a few days before going to surgery because it helps reduce the risk of bleeding complications and encourages clotting and wound healing post-surgery.
  • Kidney Conditions: Administering the medication to people suffering from chronic kidney disease can cause the build of Pradaxa in their bloodstream and intensify side effects such as bleeding.

Side Effects of Pradaxa

While Pradaxa is effective in managing the risk of thrombotic events, it has adverse side effects that need careful consideration before taking it. Understanding the side effects helps most patients optimize the balance between the therapeutic benefits and risks of Pradaxa therapy. The side effects can either be mild or severe and may not affect every patient.

Common Side Effects

  • Upset stomach
  • Heartburn
  • Mouth ulcers
  • Coughing
  • Vomiting blood
  • Tarry, black stool
  • Diarrhoea
  • Nausea

Severe Side Effects

  • Blood clots around your spine
  • Blood in your urine
  • Chest pain or tightness
  • Unusual bleeding
  • Trouble breathing
  • Allergic reaction
  • Stroke

Drug Interactions with Pradaxa

Being aware of potential drug interactions is important to ensuring patient safety and treatment efficacy. Given the widespread use of Pradaxa, it is essential to recognize how the medication may interact with other prescription medicines, dietary supplements, as well as over-the-counter drugs.

Drug Interaction
ClopidogrelUsing clopidogrel concurrently with Pradaxa increases the risk of bleeding due to reduced effects of platelet function with side effects such as nosebleeds and gastrointestinal bleeding.
VerapamilCombining Pradaxa and Verapamil leads to enhanced anticoagulant effects potentially resulting in bleeding manifestations such as hematomas and epistaxis.
AspirinThe interaction between aspirin and Pradaxa leads to an increased risk of gastrointestinal bleeding, bruising, or prolonged bleeding time due to its antiplatelet effects.
AmiodaroneConcurrent use of Pradaxa and amiodarone can heighten the risk of bleeding events, including hematomas, intracranial haemorrhage, and gastrointestinal bleeding.
CYP3A4 Inducers such as phenytoinCYP3A4 inducers like phenytoin may accelerate the metabolism of Pradaxa leading to decreased anticoagulant efficacy resulting in inadequate thromboprophylaxis and thrombotic events like stroke.
RifampinUsing Rifampin while taking Pradaxa leads to decreased anticoagulant effects, this may compromise thromboprophylaxis and increase the risk of thromboembolic events.

Strengths and Dosages of Pradaxa

The strength and dosage of Pradaxa will be determined by various factors such as your age, your body weight (especially in children), the condition being treated, and the health of your kidney. However, you need to follow your doctor’s prescription.

The medication is available as an oral capsule which should be swallowed as a whole. Do not chew, break, or open it. Pradaxa can be taken with or without food, but take it with a full glass of water.

Weight in Kg Dosing No. of Times a Day
Children weighing 11kg to less than 16 kg


One 75mgTwice daily 12 hours apart
Children weighing 16 kg to less than 26 kg


One 110mgTwice daily 12 hours apart
Children weighing 26kg to less than 41 kg


One 150mgTwice daily 12 hours apart
Adults weighing 41 kg to less than 61 kg


One 185mgTwice daily 12 hours apart
Adults weighing 61 kg to less than 81 kg


One 220mgTwice daily 12 hours apart
Adults weighing above 81 kg



One 260mgTwice daily 12 hours apart

Cost of Pradaxa in America

The price for a 60-capsule supply of Pradaxa oral capsule, 75mg, is approximately $218, but this varies depending on the pharmacy you go to. The mentioned prices are for patients paying out of pocket and may not apply if you have medical insurance coverage.

Why is Pradaxa so Expensive?

Pradaxa is a brand medication manufactured and marketed by Boehringer Ingelheim. Brand-name medications usually have higher prices compared to their generic version.

Also, the medication belongs to a new class of anticoagulant medication called Direct Oral Anticoagulants (DOACs). These drugs are more effective and offer convenience, which comes at a higher cost compared to older anticoagulants like warfarin.

Pradaxa Alternatives

There are alternative medications to Pradaxa that offer comparable efficacy with distinct advantages. By examining these alternative medications healthcare providers can make informed choices tailored to patients’ needs, optimizing the management of thrombotic disorders while minimizing potential risks and complications. The alternatives include:

Pradaxa (Dabigatran Etexilate) FAQs

How do you know that Pradaxa is working?

A blood test can be conducted to assess the effectiveness of Pradaxa in your body and determine how well the medication is working.

What are the bad side effects of Pradaxa?

The bad side effects of Pradaxa include bleeding, gastrointestinal conditions, allergic reactions, heartburn, liver conditions, and blood in the urine.

Who makes Pradaxa?

Pradaxa is manufactured by Boehringer Ingelheim a global pharmaceutical company.

What is the most common side effect of Pradaxa?

The most common side effects of Pradaxa include bleeding and stomach upset.

Which is better Pradaxa or Eliquis?

Eliquis is commonly preferred over Pradaxa due to its lack of requirement for regular blood tests, fewer interactions with food and drugs, and a lower likelihood of causing bleeding.

How to stop taking Pradaxa?

If you need to stop Pradaxa, consult your doctor for specific instructions on stopping the medication.

How long can you stay on Pradaxa?

How long you’ll take Pradaxa will depend on the conditions you’re suffering from. If you have a blood clot, you should stay on Pradaxa for at least 3 months, depending on the cause of the clot. In case you’re taking it for hip joint replacement, expect to take the medication for 4 to 5 weeks.

What to avoid when taking Pradaxa?

When taking Pradaxa, avoid alcohol, other blood thinners, NSAID drugs, and grapefruit or its juice, as they can increase the risk of bleeding complications.

What happens when you stop taking Pradaxa?

If you stop taking Pradaxa, it might increase the risk of having a stroke or blood clot formation in your body.

What happens if I miss a dose of Pradaxa?

Missing a dose of Pradaxa could potentially increase your risk of developing blood clots.

What happens if I take too much Pradaxa?

Taking too much Pradaxa can increase the risk of bleeding, including serious internal bleeding complications and haemorrhage.

When do I stop taking Pradaxa prior to surgery?

You can stop taking Pradaxa for 2-3 days before major surgery and one day before minor surgery.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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