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Details

Stereochemistry ACHIRAL
Molecular Formula C27H29N7O3
Molecular Weight 499.5643
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of Dabigatran ethyl ester

SMILES

CCOC(=O)CCN(C(=O)C1=CC2=C(C=C1)N(C)C(CNC3=CC=C(C=C3)C(N)=N)=N2)C4=NC=CC=C4

InChI

InChIKey=BGLLICFSSKPUMR-UHFFFAOYSA-N
InChI=1S/C27H29N7O3/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/h4-12,14,16,31H,3,13,15,17H2,1-2H3,(H3,28,29)

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
Peptidomimetic thrombin inhibitors.
2003 Sep-2004 Dec
Dose escalating safety study of a new oral direct thrombin inhibitor, dabigatran etexilate, in patients undergoing total hip replacement: BISTRO I.
2004 Sep
Emerging anticoagulants: mechanism of action and future potential.
2006 Mar
Recent developments in antithrombotic therapy: will sodium warfarin be a drug of the past?
2006 Nov
Dabigatran versus enoxaparin after total hip replacement.
2007 Dec 15
Why differentiate low molecular weight heparins for venous thromboembolism?
2007 Jun 19
Dabigatran with or without concomitant aspirin compared with warfarin alone in patients with nonvalvular atrial fibrillation (PETRO Study).
2007 Nov 1
The new anticoagulants.
2007 Sep
The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects.
2007 Sep
Brave new world: the current and future use of novel anticoagulants.
2008
Dabigatran etexilate.
2008
Clinical pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor dabigatran etexilate.
2008
Pharmacokinetics and pharmacodynamics of the direct oral thrombin inhibitor dabigatran in healthy elderly subjects.
2008
[New anticoagulants].
2008 Feb
Update on atrial fibrillation: part I.
2008 Feb
The metabolism and disposition of the oral direct thrombin inhibitor, dabigatran, in humans.
2008 Feb
[New oral anticoagulants: molecular characteristics, mechanisms of action, pharmacokinetics and pharmacodynamics].
2008 Nov
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
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 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
Rationale and design of RE-LY: randomized evaluation of long-term anticoagulant therapy, warfarin, compared with dabigatran.
2009 May
[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
Adherence to a new oral anticoagulant treatment prescription: dabigatran etexilate.
2009 Nov 3
Dabigatran versus warfarin in patients with atrial fibrillation.
2009 Sep 17
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: a new therapeutic option for therapy and prophylaxis of thromboembolic diseases?].
2010 Feb
The new oral anticoagulants.
2010 Jan 7
Insights from the dabigatran versus warfarin in patients with atrial fibrillation (RE-LY) trial.
2010 Mar
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
Common Name English
BIBR-951
Code English
Dabigatran etexilate related compound B [USP]
Common Name English
β-Alanine, N-[[2-[[[4-(aminoiminomethyl)phenyl]amino]methyl]-1-methyl-1H-benzimidazol-5-yl]carbonyl]-N-2-pyridinyl-, ethyl ester
Systematic Name English
Ethyl 3-(2-(((4-carbamimidoylphenyl)amino)methyl)-1-methyl-N-(pyridin-2-yl)-1H-benzimidazole-5-carboxamido)propanoate
Systematic Name English
BIBR0951
Code English
BIBR-951CL
Code English
Code System Code Type Description
FDA UNII
KJ4EH9410G
Created by admin on Sat Dec 16 08:04:38 GMT 2023 , Edited by admin on Sat Dec 16 08:04:38 GMT 2023
PRIMARY
CAS
429658-95-7
Created by admin on Sat Dec 16 08:04:38 GMT 2023 , Edited by admin on Sat Dec 16 08:04:38 GMT 2023
PRIMARY
EPA CompTox
DTXSID40332231
Created by admin on Sat Dec 16 08:04:38 GMT 2023 , Edited by admin on Sat Dec 16 08:04:38 GMT 2023
PRIMARY
PUBCHEM
446804
Created by admin on Sat Dec 16 08:04:38 GMT 2023 , Edited by admin on Sat Dec 16 08:04:38 GMT 2023
PRIMARY