Dabigatran (Pradaxa) is a direct thrombin inhibitor used to prevent thromboembolism in patients with non-valvular atrial fibrillation and atrial flutter. Dabigatran is administered orally and does not require monitoring of the protime (PT) since the pharmacokinetics are predictable, unlike those of warfarin. Dabigatran is renally cleared and the dose should be reduced in half when renal dysfunction is present (contraindicated in end-stage renal disease). Gastrointestinal upset is common including dyspepsia and esophageal reflux symptoms.