What is the effect of stopping Pradaxa?

Question

Hello doctor,

My wife just started on Pradaxa (blood thinner) a week back. She has an antiphospholipid antibody, but she has not had any clots before. We started seeing a couple of small bruises today in her hand without any injury. I want to know if we need to stop it. We consulted a doctor in the next couple of days but needed a second opinion on it.

What would be the effect if we stopped taking Pradaxa? What is the other alternative?

Does she need to be on the blood thinner, even though she has not developed any clots yet? She was allergic to aspirin, so she could not take that.

The lab test report says that her antiphospholipid antibodies were high, and as per the hematologist, she is at high risk for a clot.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

How was she diagnosed with APS (antiphospholipid antibody syndrome)? She most likely has an incidental APS, and I doubt if there are any recommendations to use anticoagulation in this particular group (positive antibodies with no clots).

Now coming to your question, Pradaxa (Dabigatran), as you know, is a blood thinner, and it will predispose her to have bruises, which are mostly harmless. What you need to look for is a huge hematoma (collection of blood beneath the skin) and blood in stools and urine.

If you have discussed with your doctor continuing the Pradaxa for prophylaxis of DVT (deep vein thrombosis) and PE (pulmonary embolism), then do not discontinue it, although, as I mentioned earlier, it is controversial.

I hope this helps.