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: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.