Dabigatran

This is the first new oral anticoagulant to be licensed in the UK for decades.

It is one of a family of drugs derived from research into the anticoagulant produced by the leech, Hirudo medicinalis.

It is an oral thrombin inhibitor.

It is thought to have fewer drug interactions than warfarin as it does not affect the cytochrome P450 enzymes

It has been recommended by NICE for hip & knee replacement surgery.

And has been licensed by the European Commission for these types of surgery.

Results from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) showed it to be as effective as warfarin.

This was in patients with atrial fibrillation and it was noted to cause fewer problems with bleeding.

It may one day be a useful drug in obstetrics.

But lack of safety precludes its use in pregnancy and during lactation for the time being.

I anticipate you will be hearing about it.

Probably first of all in gynaecology.

And for patients who are allergic to heparin.