Dabigatran assay levels
Dabigatran assay levels are not routinely required for patients taking Dabigatran. If required they can be performed 7 days a week from 8am to 11pm. Levels are not available after 11 pm unless approved by the on call haematologist. A TCT <40 sec (showing minimal Dabigatran effect) or >80 sec (showing evidence of Dabigatran induced coagulation) will not be run for a dabigatran assay unless discussed with a haematologist.
2.7 ml sodium citrate tube (light blue)
1.8 ml paediatric sodium citrate tube (light blue)
Sample must be received in the Laboratory, separated & frozen within 4 hours of collection. If despatched from outside Hospital serum must still be frozen on arrival in Laboratory.
By arrangement with Laboratory
Batched weekly, 2 hours if urgent
There is no established therapeutic range for Dabigatran (Pradaxa) with levels being dependent on renal function, age, weight and female sex.
Published data (RELY study) shows the following mean peak and trough levels for the 110 mg bd, 150 mg bd and 220 mg od dosages. Note there is no data for the 75 mg bd dose. The range is very wide.
Peak Trough 220 mg od 180 ng/ml 37 ng/ml 150 mg bd 180 ng/ml 91 ng/ml 110 mg bd 126 ng/ml 65 ng/ml
The assay must be interpreted in the context of the timing of the last dose. Routine monitoring of Dabigatran therapy is not recommended.
Comment by Dr H. Moore (Haematologist)