James A. Reiffel, MD - Novel Oral Anticoagulants - Figure 12
Metabolic Pathway of Dabigatran
DABIGATRAN
The first NOAC to be approved in the United States was the DTI, dabigatran (Pradaxa; Boehringer Ingelheim).[104]
As shown in the Figure, this agent is absorbed from the gut and is rapidly converted to an active form by serum esterases. It is also conjugated to an active form in the liver, and in both of these forms dabigatran is an effective anticoagulant. However dabigatran is about 80% renally excreted, so it is important that dabigatran dosing must be modified according to the patient’s renal function.
Reiffel JA. Am J Med 2013; 126: 00-00.