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A review on increasing risk for gastrointestinal bleeding associated with dabigatran

  • Qingsheng Niu1,†
  • Ge Yang2,†
  • Peng Liu1
  • Yaowen Jiang1,*,

1Department of Emergency Medicine, Laboratory of Emergency Medicine, West China Hospital of Sichuan University, West China School of Medicine & Disaster Medical Center, Sichuan University, 610041 Chengdu, Sichuan, China

2Department of Critical Care Medicine, Zhongshan People’s Hospital, 528403 Zhongshan, Guangdong, China

DOI: 10.22514/sv.2024.014 Vol.20,Issue 2,February 2024 pp.13-21

Submitted: 12 June 2023 Accepted: 03 August 2023

Published: 08 February 2024

*Corresponding Author(s): Yaowen Jiang E-mail:

† These authors contributed equally.


Dabigatran, a reversible direct thrombin inhibitor, is widely used in clinical practice as a therapeutic option due to its unique mechanism of action in comparison to other anticoagulants. Although patients taking dabigatran experience a reduced risk of fatal bleeding, a higher risk of gastrointestinal bleeding (GIB) is associated with dabigatran, and its rational use between anticoagulation and bleeding is challenging for clinicians. To prevent GIB, it is imperative for clinicians to understand the pharmacological characteristics of dabigatran to ensure that its prescription should be avoided in patients with bleeding. In this review, we summarize the mechanism of action and pharmacokinetics of dabigatran and bleeding sites in the gastrointestinal tract in patients treated with dabigatran, as well as discuss the factors that increase the risk of dabigatran-induced GIB, including dose, age, drug interactions, race, genetics and past medical history. Finally, the treatment and prevention of GIB with dabigatran is also discussed. This review will help clinicians choose their drugs and doses more carefully for treating GIB.


Dabigatran; Gastrointestinal bleeding; Risk factors; Treatment

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Qingsheng Niu,Ge Yang,Peng Liu,Yaowen Jiang. A review on increasing risk for gastrointestinal bleeding associated with dabigatran. SignaVitae. 2024. 20(2);13-21.


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