Drug Interaction Report

ADJUST DOSING INTERVAL: Coadministration with an antacid may reduce the bioavailability of dabigatran following oral administration of dabigatran etexilate. The mechanism of interaction has not been described. In population pharmacokinetic analyses, a reduction in dabigatran exposure by 35% was seen over the first 24 hours following surgery. Thereafter, a reduction of about 11% was observed.

MANAGEMENT: Dabigatran should be administered at least two hours before taking an antacid. Coadministration with dabigatran should be avoided within 24 hours after orthopedic surgery.

ADJUST DOSING INTERVAL: Administration with food may increase the absorption of calcium. However, foods high in oxalic acid (spinach or rhubarb), or phytic acid (bran and whole grains) may decrease calcium absorption.

MANAGEMENT: Calcium may be administered with food to increase absorption. Consider withholding calcium administration for at least 2 hours before or after consuming foods high in oxalic acid or phytic acid.

ADJUST DOSING INTERVAL: Bulk-forming laxatives such as guar gum, psyllium, polycarbophil, or methylcellulose may affect the bioavailability of concomitantly administered substances due to their effect on the rate of gastrointestinal transit and gastric emptying.

MANAGEMENT: In general, oral medications should be administered at least 2 hours before or 2 hours after dosing of the bulk-forming laxative.