Drug interactions
Dabigatran + Quinidine
Severity: Major
Dabigatran and Quinidine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Quinidine inhibits P-gp, which increases absorption of dabigatran etexilate and raises dabigatran exposure. The risk of bleeding rises, particularly in patients with renal impairment.
What this interaction means in plain words
Dabigatran and Quinidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Quinidine inhibits intestinal and renal P-gp, increasing dabigatran absorption and reducing its clearance.
What to do
Avoid the combination in patients with significant renal impairment as per labeling; otherwise consider dabigatran dose reduction and monitor for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
Frequently asked questions
Can I take Dabigatran with Quinidine?
MediHelp rates the interaction as major. Dabigatran and Quinidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Quinidine inhibits P-gp, which increases absorption of dabigatran etexilate and raises dabigatran exposure. The risk of bleeding rises, particularly in patients with renal impairment.
How serious is the interaction between Dabigatran and Quinidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in patients with significant renal impairment as per labeling; otherwise consider dabigatran dose reduction and monitor for bleeding.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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