From the Guidelines
The dose of Pradaxa (dabigatran) equivalent to Eliquis (apixaban) cannot be directly compared due to their different mechanisms of action, but the standard dose of Pradaxa is 150 mg twice daily, whereas Eliquis is typically dosed at 5 mg twice daily, with adjustments for certain patient factors 1. When considering the transition from Eliquis to Pradaxa, it's essential to understand that these medications have different pharmacological profiles. Pradaxa acts as a direct thrombin inhibitor, while Eliquis works as an anti-factor Xa inhibitor.
- The approved dose of Pradaxa is 150 mg twice daily, with potential reductions to 75 mg twice daily in patients with severe renal impairment, as indicated by the US Food and Drug Administration 1.
- In contrast, Eliquis is generally dosed at 5 mg twice daily, with dose reductions to 2.5 mg twice daily for patients meeting specific criteria, such as age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL 1. Key considerations for switching between these medications include:
- Timing: Pradaxa should typically be initiated 12 hours after the last dose of Eliquis, taking into account the patient's kidney function 1.
- Mechanism of action: The difference in how Pradaxa and Eliquis work means that switching between them requires careful medical supervision to avoid either under- or over-anticoagulation, which could lead to increased risks of stroke or bleeding, respectively. Given the complexities and the need for individualized patient care, any decision to switch between Pradaxa and Eliquis should be made under the guidance of a healthcare provider, considering the patient's specific clinical profile, including renal function, age, weight, and other risk factors for bleeding or stroke 1.
From the Research
Dose Comparison of Pradaxa (Dabigatran) and Eliquis (Apixaban)
- The provided studies do not directly compare the doses of Pradaxa (dabigatran) and Eliquis (apixaban) 2, 3, 4, 5, 6.
- However, the studies provide information on the standard and reduced doses of dabigatran and apixaban:
- Dabigatran: standard dose of 150 mg twice daily, reduced dose of 110 mg twice daily 3.
- Apixaban: standard dose of 5 mg twice daily, reduced dose of 2.5 mg twice daily (not explicitly mentioned in the provided studies, but known from other sources).
- A study comparing the effectiveness and safety of dabigatran, rivaroxaban, and apixaban in atrial fibrillation found that patients treated with standard dose apixaban or dabigatran had a lower risk of major bleeding than patients treated with rivaroxaban 6.
- Another study found that among patients with nonvalvular atrial fibrillation, dabigatran and apixaban were associated with a more favorable benefit-harm profile than rivaroxaban 5.
- There is no direct information on the equivalent dose of Pradaxa (dabigatran) to Eliquis (apixaban) in the provided studies 2, 3, 4, 5, 6.