Patients with an irregular heart rhythm called atrial fibrillation (AFib) are frequently prescribed an anticoagulant to prevent blood clots. But adding another common cardiovascular drug might be dangerous. What is this risky heart drug combo?
Anticoaguants for AFib:
One of the more popular medications for clot prevention is called Pradaxa, known generically as dabigatran. It is important for people with AFib to be protected against clots, because their blood doesn’t circulate smoothly through the heart as it should. If it gets trapped in eddies, it might clot unless the person is taking an anticoagulant. From the heart, a clot could travel to the brain and cause a stroke, or get stuck in the lung as a pulmonary embolism.
Watch Out for This Heart Drug Combo:
New research shows that when dabigatran is combined with a cholesterol-lowering drug such as simvastatin or lovastatin, patients have an increased risk for hemorrhage. These statins increase blood levels of dabigatran, and that raises the chance of excessive bleeding.
One way to avoid this problem would be to use a different statin to control cholesterol. Agents such as atorvastatin or rosuvastatin do not appear to interact with Pradaxa and increase the likelihood of hemorrhage. Accordingly, either Crestor or Lipitor would be better in a Pradaxa heart drug combo.
CMAJ, online November 21, 2016
Previous research has shown that people taking Pradaxa for AFib need to stop taking it before surgery or biopsy. You can read what we wrote about that problem here.
Fortunately, there is a medication to reverse bleeding due to Pradaxa. But unless a person is already hospitalized, it might be difficult to administer it quickly enough.
