Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation

Dabigatran etexilate is recommended as an option for the prevention of stroke and systemic embolism within its licensed indication, that is, in people with non-valvular atrial fibrillation with 1 or more of the following risk factors:

• previous stroke, transient ischaemic attack or systemic embolism

• left ventricular ejection fraction below 40%

• symptomatic heart failure of New York Heart Association (NYHA) class 2 or above

• age 75 years or older

• age 65 years or older with 1 of the following: diabetes mellitus, coronary artery disease or hypertension.

Decide whether to start treatment with dabigatran etexilate after an informed discussion with the person about its risks and benefits compared with warfarin, apixaban, edoxaban and rivaroxaban. For people taking warfarin, consider the potential risks and benefits of switching to dabigatran etexilate taking into account their level of international normalised ratio (INR) control.