Does your grandfather have atrial fibrillation? As of right now, that is the only indication that Pradaxa has. (It hasn’t been studied for DVT risks…yet)
In the studies that have been published so far (including the ones that led to FDA approval), Pradaxa is just as effective as warfarin (Coumadin) in preventing strokes and MI’s in afib patients, and actually more effective then warfarin in patients who weren’t closely monitored. Pradaxa has mostly the same risks of unwanted bleeding as warfarin in normal use (including hemorrhagic stroke [bleeding in the brain, VERY bad]).
Pradaxa doesn’t have the same monitoring requirements, and doesn’t have nearly as many drug-drug, or drug-food interactions as warfarin. The one side effect that Pradaxa has greater then warfarin is dyspepsia (gas, burping, etc). This is because the drug requires an acid environment, and contains some of its own acid in the capsule so it works best. So… Don’t take antacids at the same time as taking Pradaxa.
The major problem with Pradaxa… It doesn’t have a reversal agent. As of right now, there is no drug that will reverse the effect of Pradaxa in case of overdose, or excess bleeding. If someone does have abnormal bleeding on Pradaxa, there are currently two choices, give them fresh frozen plasma (blood products that contain all the clotting factors that Pradaxa blocks), and/or give them dialysis to clear the drug from their system. Also, the medication is VERY sensitive to humidity. Once a bottle is opened, it expires in 30 days. It must be kept in the original bottle (the lid has a desiccant to combat humidity). Make sure you don’t keep it in the bathroom… Also, it is taken twice a day (as close to 12 hours apart as possible, without interrupting sleep), instead of once a day like warfarin.
Bottom Line: If I had a family member that had afib, and that their insurance would cover Pradaxa (or the cost is worth the time), I wouldn’t have a problem recommending it to them over warfarin.
Hirka T’Bawa PharmD.
Disclaimer: While I am a pharmacist, I’m not your or your grandfathers pharmacist. I am most likely not licensed in your state, and hell, I could be lying for all you know. You know what they say about free advice? If you’re really worried, go to your local pharmacy and ask to speak to the pharmacist. They can answer all your questions for you.
ETA: Oh, sorry for the late response, I actually saw this post after you posted it, but was at work and didn’t have time to respond as well as I would want to (plus saw on my phone). Then my birthday came and went, I totally forgot about it until I was reminded today about it. Hope the response was worth the wait.