Subconjuntival haemorrhage after taking Dabigatran.

I had one of these after I took Dabigatran after my PAF diagnosis. As I am CHADS 1 the doctor took me off the Dabigatran right away. But obviously, I will have to be anticoagukated for an ablation and am worried that this problem could recur. The subconjunctival haemmorage wasn’t in any way serious, but, presumably, the bleeding could have been more serious. Has anyone experienced this problem or know anything about it?

[Hidden]

Hi Samazeuilh,

The following is an extract of an Australian report :

"Dabigatran is an oral anticoagulant medicine used for the prevention of clots and emboli after major orthopaedic surgery (hip or knee replacement) and to prevent stroke and other systemic emboli in people with non-valvular atrial fibrillation (AF), a commonly occurring abnormal heart rhythm. As with any anticoagulants, including warfarin, there is a risk of bleeding when using this medicine.

The TGA has completed two safety reviews of dabigatran - one completed in August 2012 and the other in April 2013. These reviews included consideration of advice from the Advisory Committee on the Safety of Medicines (ACSOM). Both reviews reinforced the importance of appropriate patient selection for the safe use of dabigatran. In particular, when making a decision to prescribe dabigatran, a careful assessment of the risk factors for bleeding needs to be undertaken."

For the full advice try this link

tga.gov.au/alert/dabigatran...

Any problems with accessing this link let me know.

The first questions in my mind would be ............ why were you put on it in the first place and what steps were taken to ensure you were suitable.

John

[Hidden in reply to Hidden]

Thanks for the reply. Very interesting article which shows just how dodgy Dabigatran is.

[Bagrat in reply to Hidden]

Not dodgy, just need to be aware. Also bear in mind this article is 5 years old which when discussing a new ( in pharmaceutical terms) drug, is almost half the age of the drug. First launched uk in 2008

[Hidden in reply to Hidden]

No, the article does not suggest that Dabigatran is “dodgy”

I think you should perhaps consider whether your anxiety may lead you to undermine the confidence that others have in their medication and/or procedures.

[Hidden in reply to Hidden]

The article includes reference to adverse events reported to the TGA for dabigatran. My description of dabigatran as “dodgy” was just a colloquial way of referring to

[Hidden in reply to Hidden]

The article includes reference to adverse events reported to the TGA for dabigatran. My description of dabigatran as “dodgy” was just a colloquial way of referring to the potential of this medicine to bring about such events. I don’t think that referring to the shortcomings of dabigatran, or any other medicine, should be disallowed in case it undermines confidence others might have in it. If there are risks or issues with dabigatran, it is appropriate to discuss those openly.

[Hidden]

Yes I have had several while taking warfarin. Didn’t know I had them until family mentioned them. Didn’t occur to me to do anything about them or stop the warfarin since my INR was fine.

I think that most of the time they are not a big deal

moorfields.nhs.uk/content/s...

[doodle68]

I had one in the first few weeks of taking Apixaban and thought nothing of it , it looked a bit gruesome but didn't hurt. I applied a cold pack and it went away in a few days.

Having one certainly wouldn't deter me from taking an anticoagulant.

[Hidden in reply to doodle68]

I was told by a GP that dabigatran (and presumably the other anticoagulants) have the potential to cause bleeding into the retina which would be a much more serious matter- hence the concern. Of course, the subconjunctival haemorrhage involving only the sclera is not itself serious.

[doodle68 in reply to Hidden]

Sam that does bother me, I have a CHADS score of 3 so the potential to have a stroke

if I don't take an anticoagulant makes other lesser conditions seem insignificant in comparison.

[Bagrat]

This was a small study and concerns warfarin. I can see no reason why NOAC results would differ

ncbi.nlm.nih.gov/m/pubmed/1...

Indeed tbe study cited below says just that jamanetwork.com/journals/ja...

[Hidden in reply to Bagrat]

Thanks for posting these studies which are to a degree reassuring. I will discuss with the EP when I have my assessment for the abalation.

[Hidden]

As highlighted in the Moorfields link I posted above, INR should be checked if taking warfarin. Less obvious is that a blood pressure check is recommended.