A patient who has atrial fibrillation (AF) has been taking warfarin (Coumadin). The primary care nurse practitioner (NP) plans to change the patient's medication to dabigatran (Pradaxa). To do this safely, the NP should:
a. initiate dabigatran when the patient's international normalized ratio (INR) is less than 2.
b. start dabigatran 7 to 14 days after discontinuing warfarin.
c. begin giving dabigatran 1 week before discontinuing warfarin.
d. order frequent monitoring of the patient's INR after dabigatran therapy begins.
A
There are no requirements for monitoring the INR or other measures for patients taking dabigatran. When changing from warfarin, it is recommended that dabigatran be initiated when the INR is less than 2.
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