Thromboembolic prophylaxis in orthopedic surgery using dabigatran: an oral direct thrombin inhibitor

Dabigatran etexilate is a direct thrombin inhibitor that has been in clinical use for the prevention and treatment of venous and arterial thrombosis. Dabigatran allows for oral administration, has a rapid onset of action and has a predictable anticoagulant effect. Studies in healthy volunteers and in patients undergoing orthopedic surgery indicate that dabigatran has a predictable pharmacokinetic profile, allowing for a fixed-dose regimen without the need for coagulation monitoring. Dabigatran is approved in the EU and Canada for prophylaxis of thromboembolism in patients undergoing total hip and knee arthroplasties. The focus of this article is on the clinical data of using dabigatran as venous thromboprophylaxis in orthopedic surgery patients.