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Dabigatran

From Wikipedia, the free encyclopedia

Dabigatran chemical structure
Dabigatran
Systematic (IUPAC) name
ethyl 3-(((2-(((4-((((hexyloxy)carbonyl)amino)
iminomethyl)phenyl)amino)methyl)-
1-methyl-1H-benzimidazol-5-yl)carbonyl)
(pyridin-2-yl)amino)propanoate
Identifiers
CAS number 211915-06-9
211914-51-1
ATC code  ?
PubChem 6445226
Chemical data
Formula C34H41N7O5 
Mol. weight 627.734 (471.511 without etexilate)
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life  ?
Excretion  ?
Therapeutic considerations
Pregnancy cat.

?

Legal status
Dependence Liability unknown
Routes oral

Dabigatran is an anticoagulant from the class of the direct thrombin inhibitors. It is being studied for various clinical indications, for some of which it may replace warfarin as the preferred anticoagulant. It is orally administered as the prodrug dabigatran etexilate (Rendix®). It was developed by pharmaceutical company Boehringer-Ingelheim.

Contents

[edit] Development

Dabigatran (then compound BIBR 953) was discovered from a panel of chemicals with similar structure to benzamidine-based thrombin inhibitor α-NAPAP (N-alpha-(2-naphthylsulfonylglycyl)-4-amidinophenylalanine piperidide), which had been known since the 1980s as a powerful inhibitor of various serine proteases, specifically thrombin but also trypsin. Addition of a hydrophobic side chain led to the orally absorbed prodrug BIBR 1048 (dabigatran etexilate).[1]

[edit] Dosing

A 2004 study showed a good safety profile at doses between 12.5 and 300 mg twice daily.[2]

In a phase II study comparing dabigatran with enoxaparin showed increased efficacy in preventing thrombosis in patients undergoing orthopedic surgery, but a possible increased bleeding risk in patients receiving higher doses of dabigatran.[3]

Absorption is unrelated to food but may be decreased with co-administration of proton pump inhibitors.[4]

[edit] References

  1. ^ Hauel NH, Nar H, Priepke H, Ries U, Stassen JM, Wienen W. Structure-based design of novel potent nonpeptide thrombin inhibitors. J Med Chem 2002;45:1757-66. PMID 11960487.
  2. ^ Eriksson BI, Dahl OE, Ahnfelt L, Kalebo P, Stangier J, Nehmiz G, Hermansson K, Kohlbrenner V. Dose escalating safety study of a new oral direct thrombin inhibitor, dabigatran etexilate, in patients undergoing total hip replacement: BISTRO I. J Thromb Haemost 2004;2:1573-80. PMID 15333033.
  3. ^ Eriksson BI, Dahl OE, Buller HR, Hettiarachchi R, Rosencher N, Bravo ML, Ahnfelt L, Piovella F, Stangier J, Kalebo P, Reilly P; BISTRO II Study Group. A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement: the BISTRO II randomized trial. J Thromb Haemost 2005;3:103-11. PMID 15634273.
  4. ^ Stangier J, Eriksson BI, Dahl OE, Ahnfelt L, Nehmiz G, Stahle H, Rathgen K, Svard R. Pharmacokinetic profile of the oral direct thrombin inhibitor dabigatran etexilate in healthy volunteers and patients undergoing total hip replacement. J Clin Pharmacol 2005;45:555-63. PMID 15831779.

[edit] External links


Antithrombotics (thrombolytics, anticoagulants, and antiplatelet drugs) (B01) edit
Vitamin K antagonists:

Acenocoumarol, Clorindione, Dicumarol (Dicoumarol}, Diphenadione, Ethyl biscoumacetate, Phenprocoumon, Phenindione, Tioclomarol, Warfarin

Heparin group (Platelet
aggregation inhibitors):

Antithrombin III, Bemiparin, Dalteparin, Danaparoid, Enoxaparin, Heparin, Nadroparin, Parnaparin, Reviparin, Sulodexide, Tinzaparin

Other Platelet
aggregation inhibitors:

Abciximab, Acetylsalicylic acid (Aspirin), Aloxiprin, Beraprost, Ditazole, Carbasalate calcium, Cloricromen, Clopidogrel, Dipyridamole, Epoprostenol, Eptifibatide, Indobufen, Iloprost, Picotamide, Prasugrel, Ticlopidine, Tirofiban, Treprostinil, Triflusal

Enzymes:

Alteplase, Ancrod, Anistreplase, Brinase, Drotrecogin alfa, Fibrinolysin, Protein C, Reteplase, Saruplase, Streptokinase, Tenecteplase, Urokinase

Direct thrombin inhibitors:

Argatroban, Bivalirudin, Dabigatran, Desirudin, Hirudin, Lepirudin, Melagatran, Ximelagatran

Other antithrombotics:

Dabigatran, Defibrotide, Dermatan sulfate, Fondaparinux, Rivaroxaban

Non-medicinal:

Citrate, EDTA, Oxalate

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