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Details

Stereochemistry ACHIRAL
Molecular Formula C27H29N7O3.CH4O3S
Molecular Weight 595.67
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of Dabigatran ethyl ester mesylate

SMILES

CS(O)(=O)=O.CCOC(=O)CCN(C(=O)C1=CC=C2N(C)C(CNC3=CC=C(C=C3)C(N)=N)=NC2=C1)C4=NC=CC=C4

InChI

InChIKey=QVBNKEYVFRXLHM-UHFFFAOYSA-N
InChI=1S/C27H29N7O3.CH4O3S/c1-3-37-25(35)13-15-34(23-6-4-5-14-30-23)27(36)19-9-12-22-21(16-19)32-24(33(22)2)17-31-20-10-7-18(8-11-20)26(28)29;1-5(2,3)4/h4-12,14,16,31H,3,13,15,17H2,1-2H3,(H3,28,29);1H3,(H,2,3,4)

HIDE SMILES / InChI

Description
Curator's Comment: Description was created based on several sources, including http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/022512s007lbl.pdf https://www.pradaxa.com/

Dabigatran (Pradaxa, Prazaxa) is an anticoagulant medication that can be taken by mouth. FDA approved on October 19, 2010. Dabigatran directly inhibits thrombin in a concentration-dependent, reversible, specific, and competitive manner which results in a prolongation of aPTT (partial thromboplastin time), ECT (Ecarin clotting time), and TT (thrombin time). It may increase INR but this laboratory parameter is relatively insensitive to the activity of dabigatran. Dabigatran is indicated for the prevention of venous thromboembolic events in patients who have undergone elective hip or knee replacement surgery (based on RE-NOVATE, RE-MODEL, and RE-MOBILIZE trials). In 2010, it was approved in the US and Canada for prevention of stroke and systemic embolism in patients with atrial fibrillation (approval based on the RE-LY trial). Contraindications: severe renal impairment (CrCL < 30 ml/min); haemorrhagic manifestations, bleeding diathesis or spontaneous or pharmacologic impairment of haemostasis; lesions at risk of clinically significant bleeding (e.g. extensive cerebral infarction (haemorrhagic or ischemic) in the last 6 months, active peptic ulcer disease); concomitant treatment with P-glycoprotein inhibitors (e.g. oral ketoconazole, verapamil); and those with known hypersensitivity to dabigatran, dabigatran etexilate or any ingredient used in the formulation or component of the container. As of December 2012, dabigatran is contraindicated in patients with mechanical prosthetic heart valves.

CNS Activity

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Preventing
PRADAXA

Approved Use

PRADAXA is a direct thrombin inhibitor indicated: To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (1.1) For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days (1.2) To reduce the risk of recurrence of DVT and PE in patients who have been previously treated (1.3) For the prophylaxis of DVT and PE in patients who have undergone hip replacement surgery

Launch Date

2010
Primary
PRADAXA

Approved Use

PRADAXA is a direct thrombin inhibitor indicated: To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (1.1) For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days (1.2) To reduce the risk of recurrence of DVT and PE in patients who have been previously treated (1.3) For the prophylaxis of DVT and PE in patients who have undergone hip replacement surgery

Launch Date

2010
Preventing
PRADAXA

Approved Use

PRADAXA is a direct thrombin inhibitor indicated: To reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (1.1) For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients who have been treated with a parenteral anticoagulant for 5-10 days (1.2) To reduce the risk of recurrence of DVT and PE in patients who have been previously treated (1.3) For the prophylaxis of DVT and PE in patients who have undergone hip replacement surgery

Launch Date

2010
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
348 ng/mL
150 mg 2 times / day steady-state, oral
dose: 150 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DABIGATRAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
2232 ng × h/mL
150 mg 2 times / day steady-state, oral
dose: 150 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DABIGATRAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
11.3 h
150 mg 2 times / day steady-state, oral
dose: 150 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DABIGATRAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
65%
150 mg 2 times / day steady-state, oral
dose: 150 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DABIGATRAN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
400 mg 3 times / day single, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: single
Dose: 400 mg, 3 times / day
Sources: Page: p.301
healthy, 18–45
n = 8
Health Status: healthy
Age Group: 18–45
Sex: M
Population Size: 8
Sources: Page: p.301
400 mg single, oral
Highest studied dose
Dose: 400 mg
Route: oral
Route: single
Dose: 400 mg
Sources: Page: p.301
healthy, 18–45
n = 6
Health Status: healthy
Age Group: 18–45
Sex: M
Population Size: 6
Sources: Page: p.301
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
Disc. AE: C-reactive protein increased, Alanine aminotransferase increase...
AEs leading to
discontinuation/dose reduction:
C-reactive protein increased (7.14%)
Alanine aminotransferase increase (7.14%)
Haematuria (7.14%)
Epistaxis (7.14%)
Haemorrhoidal haemorrhage (7.14%)
Sources: Page: p.605
150 mg 2 times / day multiple, oral
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.5
unhealthy
n = 6059
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Population Size: 6059
Sources: Page: p.5
Disc. AE: Bleeding, Gastrointestinal disorder NOS...
AEs leading to
discontinuation/dose reduction:
Bleeding
Gastrointestinal disorder NOS
Sources: Page: p.5
150 mg 2 times / day multiple, oral
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.6
unhealthy
n = 6059
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Population Size: 6059
Sources: Page: p.6
Disc. AE: Bleeding...
AEs leading to
discontinuation/dose reduction:
Bleeding (grade 5, 0.07%)
Sources: Page: p.6
150 mg 2 times / day multiple, oral (max)
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Sources: Page: p.1
Disc. AE: Spinal epidural hematoma, Bleeding...
AEs leading to
discontinuation/dose reduction:
Spinal epidural hematoma
Bleeding (grade 3-5)
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
Alanine aminotransferase increase 7.14%
Disc. AE
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
C-reactive protein increased 7.14%
Disc. AE
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
Epistaxis 7.14%
Disc. AE
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
Haematuria 7.14%
Disc. AE
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
Haemorrhoidal haemorrhage 7.14%
Disc. AE
150 mg 6 times / day multiple, oral
Recommended
Dose: 150 mg, 6 times / day
Route: oral
Route: multiple
Dose: 150 mg, 6 times / day
Sources: Page: p.605
healthy, 18–45
n = 14
Health Status: healthy
Age Group: 18–45
Sex: M+F
Population Size: 14
Sources: Page: p.605
Bleeding Disc. AE
150 mg 2 times / day multiple, oral
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.5
unhealthy
n = 6059
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Population Size: 6059
Sources: Page: p.5
Gastrointestinal disorder NOS Disc. AE
150 mg 2 times / day multiple, oral
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.5
unhealthy
n = 6059
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Population Size: 6059
Sources: Page: p.5
Bleeding grade 5, 0.07%
Disc. AE
150 mg 2 times / day multiple, oral
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.6
unhealthy
n = 6059
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Population Size: 6059
Sources: Page: p.6
Spinal epidural hematoma Disc. AE
150 mg 2 times / day multiple, oral (max)
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Sources: Page: p.1
Bleeding grade 3-5
Disc. AE
150 mg 2 times / day multiple, oral (max)
Recommended
Dose: 150 mg, 2 times / day
Route: oral
Route: multiple
Dose: 150 mg, 2 times / day
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: Non-valvular atrial fibrillation|deep venous thrombosis|pulmonary embolism
Sources: Page: p.1
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no [IC50 >100 uM]
no
no
no
no
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no (co-administration study)
Comment: Coadministration of Atorvastatin (CYP3A4 & P-gp inhibitor, 400 mg QD x 4 days) with Dabigatran metexilate mesylate (150 mg BID x 3 days and 150 mg QD on Day 4) decreased total Dabigatran AUCtau,ss by 58% and Cmax,ss by 50%., Coadministration of Clarithromycin (CYP3A4 & P-gp inhibitor, 500 mg BID x 5 days & 500 mg QD on Day 6) with Dabigatran metexilate mesylate (150 mg QD on Day 6) increased total Dabigatran AUCinf by 19% and Cmax by 15%., Coadministration of Rifampicin (CYP3A4 & P-gp inducer, 600 mg QD x 7 days in the night) with Dabigatran metexilate mesylate (150 mg QD on Day 8 morning) decreased total Dabigatran AUCinf by 67% and Cmax by 66%., Coadministration of Ketoconazole (CYP3A4 & P-gp inhibitor, 400mg QD ) with Dabigatran metexilate mesylate (150 mg QD) increased total Dabigatran AUCinf by 138% and Cmax by 135%.
Page: (ClinPharm) 13, (PMDA_A100_1 Japanese) 32, 40-41, (PMDA_I100_1 Japanese) 33
no
no (co-administration study)
Comment: Caco-2 cells, Efflux ratio = 1.09 (3 mcM), 0.95 (300 mcM); MDR1-LLC-PK1 cells, Efflux ratio = 1.35 (10 mcM); Coadministration of Amiodarone (P-gp & CYP2C9 inhibitor, 600 mg QD on Day 4) with Dabigatran metexilate mesylate (150 mg BID x 3 days and 150 mg QD on Day 4) increased total Dabigatran AUCtau,ss by 58% and Cmax by 50%., Coadministration of Verapamil (P-gp inhibitor, 120 mg single or multiple doses, or 240 mg single dose) with Dabigatran metexilate mesylate (150 mg single dose) increased total Dabigatran AUCinf by 39~143% and Cmax by 12~179%., Coadministration of Quinidine (200 mg every 2 hr x 5 on Day 3 (3 hr after the first Dabigatran dose), P-gp inhibitor) with Dabigatran metexilate mesylate (150 mg BID x 3 days (2nd dose on Day 3 was administrated 1 hr after the final Quinidine dose) increased total Dabigatran AUCtau,ss by 53% and Cmax,ss by 56%., Coadministration of Ketoconazole (CYP3A4 & P-gp inhibitor, 400mg QD ) with Dabigatran metexilate mesylate (150 mg QD) increased total Dabigatran AUCinf by 138% and Cmax by 135%., Coadministration of Atorvastatin (CYP3A4 & P-gp inhibitor, 400 mg QD x 4 days) with Dabigatran metexilate mesylate (150 mg BID x 3 days and 150 mg QD on Day 4) decreased total Dabigatran AUCtau,ss by 58% and Cmax,ss by 50%., Coadministration of Clarithromycin (CYP3A4 & P-gp inhibitor, 500 mg BID x 5 days & 500 mg QD on Day 6) with Dabigatran metexilate mesylate (150 mg QD on Day 6) increased total Dabigatran AUCinf by 19% and Cmax by 15%., Coadministration of Rifampicin (CYP3A4 & P-gp inducer, 600 mg QD x 7 days in the night) with Dabigatran metexilate mesylate (150 mg QD on Day 8 morning) decreased total Dabigatran AUCinf by 67% and Cmax by 66%.
Page: 54-55, 56-57, (ClinPharm) 12, 13, 33-36, (PMDA_A100_1 Japanese) 33, 39, 40-41, (PMDA_I100_1 Japanese) 66, (PMDA_K103_1 Japanese) 152-156
yes [Km 371.4 uM]
yes [Km 511.7 uM]
yes [Km 987.3 uM]
Tox targets
PubMed

PubMed

TitleDatePubMed
Recently published papers: Novel therapies in chronic obstructive pulmonary disease, cardiac chemicals and intensive care outcomes.
2009
[Dabigatran versus Warfarin in patients with atrial fibrillation. Results of the RE-LY study].
2009
A cost-effectiveness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium as thromboprophylaxis after total hip and total knee replacement in the irish healthcare setting.
2009
The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants.
2009
[New anticoagulants for secondary haemostasis--anti IIa inhibitors].
2009 Aug
Use of emerging oral anticoagulants in clinical practice: translating results from clinical trials to orthopedic and general surgical patient populations.
2009 Aug
Recent developments in the use of oral anticoagulants.
2009 Aug
Clinical trials update from the European Society of Cardiology Meeting 2009: AAA, RELY, PROTECT, ACTIVE-I, European CRT survey, German pre-SCD II registry, and MADIT-CRT.
2009 Dec
[New oral anticoagulants. Consequences for perioperative coagulation diagnostics and therapy].
2009 Dec
Oral direct thrombin inhibitor AZD0837 for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation: a randomized dose-guiding, safety, and tolerability study of four doses of AZD0837 vs. vitamin K antagonists.
2009 Dec
Dabigatran versus warfarin in the treatment of acute venous thromboembolism.
2009 Dec 10
Enhancement of pig embryonic implants in factor VIII KO mice: a novel role for the coagulation cascade in organ size control.
2009 Dec 21
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Dec 31
New anticoagulants: focus on venous thromboembolism.
2009 Jul
Dabigatran: new drug. Continue to use heparin, a better-known option.
2009 Jun
[Pharmacokinetics and pharmacodynamics of the new oral anticoagulants dabigatran and rivaroxaban].
2009 May-Jun
[Dabigatran and rivaroxaban, new oral anticoagulants for the treatment of venous thromboembolism].
2009 May-Jun
[The results of the RE-lY study promise more effective, safer and easier prevention of embolic complications in patients with non-valvular atrial fibrillation].
2009 Nov
Direct inhibitors of coagulation proteins - the end of the heparin and low-molecular-weight heparin era for anticoagulant therapy?
2009 Nov
Dabigatran, a direct thrombin inhibitor, demonstrates antifibrotic effects on lung fibroblasts.
2009 Nov
The RE-LY study: Randomized Evaluation of Long-term anticoagulant therapY: dabigatran vs. warfarin.
2009 Nov
Adherence to a new oral anticoagulant treatment prescription: dabigatran etexilate.
2009 Nov 3
Dabigatran etexilate in venous thromboembolism.
2009 Oct
Rivaroxaban for the prevention of venous thromboembolism: a single technology appraisal.
2009 Oct
[New developments in antithrombotic care].
2009 Sep
[Dabigatran: clinical pharmacology].
2009 Sep
[Perspectives in cardiology: evidence of efficacy in atrial fibrillation and hopes in acute coronary syndrome].
2009 Sep
[Anticoagulants drugs direct trombin inhibitors].
2009 Sep
[Dabigatran (Pradaxa): efficacy and safety].
2009 Sep
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Sep 17
Dabigatran: safer, more effective and easier to use than warfarin.
2009 Sep-Oct
Oral antithrombotic inhibitors: dabigatran etexilate, meeting an unmet need?
2009 Sep-Oct
Pharmacology, pharmacokinetics, and pharmacodynamics of dabigatran etexilate, an oral direct thrombin inhibitor.
2009 Sep-Oct
Dabigatran enhances clot susceptibility to fibrinolysis by mechanisms dependent on and independent of thrombin-activatable fibrinolysis inhibitor.
2010 Apr
[Dabigatran: a new therapeutic option for therapy and prophylaxis of thromboembolic diseases?].
2010 Feb
Replacing aspirin and warfarin for secondary stroke prevention: is it worth the costs?
2010 Feb
New oral anticoagulants: a practical guide for clinicians.
2010 Feb
The potential benefits of low-molecular-weight heparins in cancer patients.
2010 Jan 14
The new oral anticoagulants.
2010 Jan 7
Does dabigatran improve stroke prevention in atrial fibrillation? A rebuttal.
2010 Jun
Thrombin-induced CCN2 expression as a target for anti-fibrotic therapy in scleroderma.
2010 Jun
Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development.
2010 Mar
Insights from the dabigatran versus warfarin in patients with atrial fibrillation (RE-LY) trial.
2010 Mar
[Oral prevention of thromboembolism with rivaroxaban and dabigatran: are the newly approved drugs innovations in orthopaedic and trauma surgery? ].
2010 Sep
Dabigatran and dabigatran ethyl ester: potent inhibitors of ribosyldihydronicotinamide dehydrogenase (NQO2).
2012 Apr 26
Patents

Sample Use Guides

In Vivo Use Guide
Unknown
Route of Administration: Unknown
In Vitro Use Guide
Unknown
Name Type Language
Dabigatran ethyl ester mesylate
Common Name English
Ethyl 3-(2-(((4-carbamimidoylphenyl)amino)methyl)-1-methyl-N-(pyridin-2-yl)-1H-benzimidazole-5-carboxamido)propanoate monomethanesulfonate
Systematic Name English
Dabigatran etexilate related compound B mesylate
Common Name English
β-Alanine, N-[[2-[[[4-(aminoiminomethyl)phenyl]amino]methyl]-1-methyl-1H-benzimidazol-5-yl]carbonyl]-N-2-pyridinyl-, ethyl ester, methanesulfonate (1:1)
Systematic Name English
Code System Code Type Description
FDA UNII
EJ6LF8QCV8
Created by admin on Sat Dec 16 19:18:09 GMT 2023 , Edited by admin on Sat Dec 16 19:18:09 GMT 2023
PRIMARY
PUBCHEM
72192622
Created by admin on Sat Dec 16 19:18:09 GMT 2023 , Edited by admin on Sat Dec 16 19:18:09 GMT 2023
PRIMARY
CAS
1466608-48-9
Created by admin on Sat Dec 16 19:18:09 GMT 2023 , Edited by admin on Sat Dec 16 19:18:09 GMT 2023
PRIMARY