Drug interactions
Dabigatran etexilate + Phenobarbital
Severity: Major
Dabigatran etexilate and Phenobarbital: 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
Phenobarbital induces P-gp and may reduce dabigatran absorption and plasma levels. Loss of anticoagulant effect increases the risk of stroke and thromboembolism.
What this interaction means in plain words
Dabigatran etexilate and Phenobarbital 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
Induction of P-glycoprotein by phenobarbital increases dabigatran efflux and lowers absorption.
What to do
Avoid concurrent use and consider an alternative anticonvulsant or an anticoagulant not affected by P-gp induction, such as warfarin. If unavoidable, monitor for thromboembolic events.
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 Dabigatran etexilate
- Dabigatran etexilate + Defibrotide Contraindicated
- Dabigatran etexilate + Ketorolac Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
- Abciximab + Dabigatran etexilate Major
- Alteplase + Dabigatran etexilate Major
- Amiodarone + Dabigatran etexilate Major
Frequently asked questions
Can I take Dabigatran etexilate with Phenobarbital?
MediHelp rates the interaction as major. Dabigatran etexilate and Phenobarbital 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. Phenobarbital induces P-gp and may reduce dabigatran absorption and plasma levels. Loss of anticoagulant effect increases the risk of stroke and thromboembolism.
How serious is the interaction between Dabigatran etexilate and Phenobarbital?
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 concurrent use and consider an alternative anticonvulsant or an anticoagulant not affected by P-gp induction, such as warfarin. If unavoidable, monitor for thromboembolic events.
What other medicines interact with Dabigatran etexilate?
MediHelp also lists interactions of Dabigatran etexilate with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Dabigatran etexilate page.
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