Major
Established
설명
Ibuprofen with dabigatran increases GI bleeding risk through additive effects; dabigatran itself carries a higher inherent GI bleeding risk than other DOACs.
기전
NSAIDs impair platelet function and damage gastric mucosa; dabigatran inhibits thrombin, preventing fibrin clot formation at sites of mucosal injury created by ibuprofen.
임상적 중요성
Dabigatran's GI bleeding rate is already higher than warfarin; NSAID co-administration amplifies this risk substantially.
관리 방법
Avoid combination; use acetaminophen for pain. If NSAID is unavoidable, use the lowest dose for the shortest duration with a PPI, and reassess dabigatran dose.