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.