Dabigatran Etexilate Mesylate side effects: what 72,206 FDA adverse event reports show
Drug class
Not stated in label
Who reports
72,206 reports · 76% serious · 10,779 with death outcome · 48% female
Used for
Dabigatran etexilate capsules are a direct thrombin inhibitor indicated: • To reduce the risk of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation ( 1.1 ) • For the treatment of deep venous thrombosis (DVT) and pulmon.
Boxed warning
(A) PREMATURE DISCONTINUATION OF DABIGATRAN ETEXILATE CAPSULES INCREASES THE RISK OF THROMBOTIC EVENTS, and (B) SPINAL/EPIDURAL HEMATOMA (A) PREMATURE DISCONTINUATION OF DABIGATRAN ETEXILATE CAPSULES INCREASES THE RI.
Causality screen of the 40 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,190 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Procoagulant therapy | 737 | 17,539.0 9,915.4–31,024.4ROR 17,719.9 · calibrated p 9e-31 ✓ | 279.9 EB05 263.4 · IC025 +7.8 3/3 methods agree | Reporting / coding artifact | serious n=733 | no trial arm names this drug |
| Thrombin time abnormal | 22 | 285.6 158.2–515.6ROR 285.7 · calibrated p 4e-10 ✓ | 127.7 EB05 88.9 · IC025 +4.4 3/3 methods agree | Lab value / disease marker | serious n=20 · 100% clinician | no trial arm names this drug |
| Thrombin time prolonged | 121 | 278.7 216.9–357.9ROR 279.1 · calibrated p 4e-11 ✓ | 138.5 EB05 119.0 · IC025 +6.2 3/3 methods agree | Lab value / disease marker | serious n=106 | no trial arm names this drug |
| International normalised ratio | 46 | 114.2 81.2–160.8ROR 114.3 · calibrated p 9e-8 ✓ | 79.3 EB05 61.8 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious n=24 | no trial arm names this drug |
| Haemorrhagic anaemia | 1,245 | 112.7 105.5–120.2ROR 114.6 · calibrated p 4e-8 ✓ | 81.0 EB05 77.3 · IC025 +6.2 3/3 methods agree | Not in label — unassessed | serious n=1,245 · 80% consumer | no trial arm names this drug |
| Activated partial thromboplastin time abnormal | 52 | 77.7 57.2–105.6ROR 77.8 · calibrated p 1e-6 ✓ | 60.0 EB05 47.6 · IC025 +4.8 3/3 methods agree | Lab value / disease marker | serious n=41 · 100% clinician | no trial arm names this drug |
| Anticoagulation drug level increased | 54 | 57.8 43.1–77.4ROR 57.8 · calibrated p 8e-6 ✓ | 47.5 EB05 37.7 · IC025 +4.6 3/3 methods agree | Lab value / disease marker | serious n=54 · 100% clinician | no trial arm names this drug |
| Lower gastrointestinal haemorrhage | 1,140 | 52.6 49.4–56.0ROR 53.5 · calibrated p 9e-6 ✓ | 44.6 EB05 42.4 · IC025 +5.4 3/3 methods agree | Labeled (related wording) related wording | serious PRR 33.6 | no trial arm names this drug |
| Atrial thrombosis | 311 | 51.0 45.2–57.5ROR 51.2 · calibrated p 1e-5 ✓ | 43.3 EB05 39.4 · IC025 +5.2 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious n=303 · 91% clinician | no trial arm names this drug |
| Ischaemic stroke | 2,184 | 40.4 38.6–42.2ROR 41.6 · calibrated p 4e-5 ✓ | 35.5 EB05 34.2 · IC025 +5.1 3/3 methods agree | Labeled (related wording) related wording | serious PRR 26.7 · 93% clinician | no trial arm names this drug |
| Cardiac valve replacement complication | 27 | 35.5 23.8–53.0ROR 35.5 · calibrated p 2e-4 ✓ | 31.1 EB05 22.4 · IC025 +3.7 3/3 methods agree | Reporting / coding artifact | serious n=26 · 100% clinician | no trial arm names this drug |
| Embolic stroke | 376 | 34.8 31.3–38.7ROR 35.0 · calibrated p 1e-4 ✓ | 31.1 EB05 28.5 · IC025 +4.7 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious n=376 | no trial arm names this drug |
| Pericardial haemorrhage | 231 | 34.2 29.8–39.1ROR 34.3 · calibrated p 1e-4 ✓ | 30.6 EB05 27.4 · IC025 +4.6 3/3 methods agree | Labeled (related wording) related wording | serious n=228 | no trial arm names this drug |
| Strangulated hernia | 24 | 33.8 22.1–51.5ROR 33.8 · calibrated p 3e-4 ✓ | 29.7 EB05 21.0 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=24 · 100% clinician | no trial arm names this drug |
| Heart transplant | 85 | 30.3 24.2–37.8ROR 30.3 · calibrated p 3e-4 ✓ | 27.3 EB05 22.8 · IC025 +4.2 3/3 methods agree | Not in label — unassessed | serious n=85 · ♀ 20% (drug 48%) | no trial arm names this drug |
| Haemorrhagic transformation stroke | 141 | 30.0 25.2–35.7ROR 30.1 · calibrated p 3e-4 ✓ | 27.2 EB05 23.6 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=141 | no trial arm names this drug |
| Gastrointestinal haemorrhage | 7,877 | 30.0 29.3–30.6ROR 33.5 · calibrated p 1e-4 ✓ | 27.2 EB05 26.7 · IC025 +4.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 20.4 | no trial arm names this drug |
| Activated partial thromboplastin time prolonged | 476 | 29.9 27.3–32.9ROR 30.1 · calibrated p 3e-4 ✓ | 27.2 EB05 25.2 · IC025 +4.6 3/3 methods agree | Lab value / disease marker | serious n=385 · 93% clinician | no trial arm names this drug |
| Brain midline shift | 50 | 29.8 22.3–39.9ROR 29.8 · calibrated p 4e-4 ✓ | 26.8 EB05 21.2 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=50 · 100% clinician | no trial arm names this drug |
| Cardiac tamponade | 413 | 27.5 24.9–30.4ROR 27.7 · calibrated p 4e-4 ✓ | 25.1 EB05 23.2 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=413 · 90% clinician | no trial arm names this drug |
| Incarcerated hernia | 25 | 25.6 17.0–38.5ROR 25.6 · calibrated p 1e-3 ✓ | 23.2 EB05 16.5 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=25 · 100% clinician | no trial arm names this drug |
| Peripheral embolism | 93 | 25.1 20.3–31.1ROR 25.2 · calibrated p 7e-4 ✓ | 23.1 EB05 19.4 · IC025 +4.0 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | serious n=87 | no trial arm names this drug |
| Diverticulitis intestinal haemorrhagic | 31 | 25.1 17.4–36.2ROR 25.1 · calibrated p 1e-3 ✓ | 22.8 EB05 16.8 · IC025 +3.5 3/3 methods agree | Labeled (related wording) related wording | serious n=29 | no trial arm names this drug |
| Haemorrhage intracranial | 1,182 | 24.8 23.4–26.3ROR 25.2 · calibrated p 7e-4 ✓ | 22.9 EB05 21.8 · IC025 +4.4 3/3 methods agree | Labeled (related wording) related wording | serious PRR 17.3 | no trial arm names this drug |
| Gastrointestinal arteriovenous malformation | 23 | 24.4 16.0–37.4ROR 24.4 · calibrated p 0.001 ✓ | 22.2 EB05 15.5 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=23 | no trial arm names this drug |
| Traumatic intracranial haemorrhage | 71 | 24.4 19.2–31.1ROR 24.4 · calibrated p 9e-4 ✓ | 22.4 EB05 18.4 · IC025 +3.9 3/3 methods agree | Labeled (related wording) related wording | serious n=71 · 100% clinician | no trial arm names this drug |
| Coagulation test abnormal | 59 | 24.3 18.6–31.7ROR 24.3 · calibrated p 9e-4 ✓ | 22.3 EB05 18.0 · IC025 +3.8 3/3 methods agree | Reporting / coding artifact | serious n=53 | no trial arm names this drug |
| Coagulopathy | 1,260 | 23.8 22.5–25.2ROR 24.2 · calibrated p 8e-4 ✓ | 22.0 EB05 21.0 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious PRR 17.0 | no trial arm names this drug |
| Blood loss anaemia | 168 | 23.6 20.2–27.6ROR 23.6 · calibrated p 1e-3 ✓ | 21.8 EB05 19.2 · IC025 +4.1 3/3 methods agree | Not in label — unassessed | serious n=167 | no trial arm names this drug |
| Upper gastrointestinal haemorrhage | 1,219 | 22.6 21.3–23.9ROR 22.9 · calibrated p 0.001 ✓ | 21.0 EB05 20.0 · IC025 +4.3 3/3 methods agree | Labeled (related wording) related wording | serious PRR 15.8 | no trial arm names this drug |
| Coagulation time prolonged | 112 | 22.4 18.5–27.2ROR 22.4 · calibrated p 0.001 ✓ | 20.8 EB05 17.8 · IC025 +3.9 3/3 methods agree | Lab value / disease marker | serious n=77 | no trial arm names this drug |
| Haemorrhagic infarction | 38 | 21.4 15.4–29.8ROR 21.5 · calibrated p 0.002 ✓ | 19.8 EB05 15.1 · IC025 +3.5 3/3 methods agree | Labeled (related wording) related wording | serious n=38 · ♀ 0% (drug 48%) | no trial arm names this drug |
| Pelvic haematoma | 30 | 21.4 14.8–31.0ROR 21.4 · calibrated p 0.002 ✓ | 19.7 EB05 14.4 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=30 · ♀ 100% (drug 48%) | no trial arm names this drug |
| Subdural haemorrhage | 189 | 21.3 18.4–24.7ROR 21.4 · calibrated p 0.002 ✓ | 19.9 EB05 17.6 · IC025 +4.0 3/3 methods agree | Labeled (related wording) related wording | serious n=188 | no trial arm names this drug |
| Cerebral artery occlusion | 73 | 21.3 16.8–27.0ROR 21.3 · calibrated p 0.002 ✓ | 19.8 EB05 16.2 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=73 | no trial arm names this drug |
| Haemothorax | 197 | 21.1 18.2–24.3ROR 21.1 · calibrated p 0.002 ✓ | 19.7 EB05 17.5 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=197 | no trial arm names this drug |
| Shock haemorrhagic | 539 | 20.6 18.9–22.4ROR 20.7 · calibrated p 0.002 ✓ | 19.2 EB05 17.9 · IC025 +4.1 3/3 methods agree | Labeled (related wording) related wording | serious PRR 14.5 | no trial arm names this drug |
| Cardiac ablation | 115 | 20.1 16.7–24.3ROR 20.2 · calibrated p 0.002 ✓ | 18.8 EB05 16.1 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious n=101 | no trial arm names this drug |
| Coagulation time shortened | 21 | 19.2 12.4–29.9ROR 19.2 · calibrated p 0.004 ✓ | 17.7 EB05 12.0 · IC025 +3.0 3/3 methods agree | Lab value / disease marker | – | no trial arm names this drug |
| Intracranial haematoma | 34 | 18.6 13.1–26.3ROR 18.6 · calibrated p 0.004 ✓ | 17.3 EB05 12.9 · IC025 +3.2 3/3 methods agree | Labeled (related wording) related wording | serious n=34 · 100% clinician | no trial arm names this drug |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Gastrointestinal haemorrhage | 7,877 | 30.0 29.3–30.6ROR 33.5 · calibrated p 1e-4 ✓ | 27.2 EB05 26.7 · IC025 +4.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 20.4 | no trial arm names this drug |
| Cerebrovascular accident (stroke) | 3,947 | 6.9 6.7–7.1ROR 7.2 · calibrated p 0.090 | 6.7 EB05 6.6 · IC025 +2.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 5.1 | no trial arm names this drug |
| Fall | 3,023 | 2.7 2.6–2.8ROR 2.7 · calibrated p 0.721 | 2.6 EB05 2.6 · IC025 +1.3 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 2.0 | no trial arm names this drug |
| Haemorrhage | 2,997 | 8.5 8.2–8.9ROR 8.9 · calibrated p 0.048 ✓ | 8.3 EB05 8.1 · IC025 +3.0 3/3 methods agree | Labeled — boxed warning synonym match | serious PRR 6.7 | no trial arm names this drug |
| Anaemia (low red blood cells) | 2,598 | 4.0 3.8–4.1ROR 4.1 · calibrated p 0.358 | 4.0 EB05 3.8 · IC025 +1.9 3/3 methods agree | Not in label — unassessed | serious PRR 3.2 | no trial arm names this drug |
| Ischaemic stroke | 2,184 | 40.4 38.6–42.2ROR 41.6 · calibrated p 4e-5 ✓ | 35.5 EB05 34.2 · IC025 +5.1 3/3 methods agree | Labeled (related wording) related wording | serious PRR 26.7 · 93% clinician | no trial arm names this drug |
| Death | 2,113 | 0.7 0.7–0.7ROR 0.7 · calibrated p 0.132 | 0.7 EB05 0.7 · IC025 -0.6 PRR-only: not supported by EBGM or IC | Outcome field, not a reaction | serious PRR 0.5 | no trial arm names this drug |
| Dyspnoea (shortness of breath) | 2,031 | 1.0 1.0–1.1ROR 1.0 · calibrated p 0.336 | 1.0 EB05 1.0 · IC025 -0.0 PRR-only: not supported by EBGM or IC | Not in label — unassessed | serious PRR 0.8 | no trial arm names this drug |
| Rectal haemorrhage | 1,980 | 13.9 13.3–14.6ROR 14.3 · calibrated p 0.008 ✓ | 13.3 EB05 12.8 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious PRR 9.6 | no trial arm names this drug |
| Dizziness | 1,928 | 1.1 1.1–1.2ROR 1.1 · calibrated p 0.392 | 1.1 EB05 1.1 · IC025 +0.1 | Not in label — unassessed | serious PRR 0.7 | no trial arm names this drug |
| Atrial fibrillation | 1,743 | 5.3 5.0–5.5ROR 5.4 · calibrated p 0.198 | 5.2 EB05 5.0 · IC025 +2.3 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 3.3 | no trial arm names this drug |
| Diarrhoea (diarrhea) | 1,655 | 0.7 0.7–0.8ROR 0.7 · calibrated p 0.151 | 0.7 EB05 0.7 · IC025 -0.5 PRR-only: not supported by EBGM or IC | Labeled adverse reaction exact term | serious PRR 0.5 | no trial arm names this drug |
| Asthenia (weakness) | 1,638 | 1.3 1.2–1.3ROR 1.3 · calibrated p 0.489 | 1.3 EB05 1.2 · IC025 +0.3 | Not in label — unassessed | serious PRR 0.9 | no trial arm names this drug |
| Dyspepsia (indigestion) | 1,520 | 4.6 4.3–4.8ROR 4.6 · calibrated p 0.279 | 4.5 EB05 4.3 · IC025 +2.1 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 1.9 · 77% consumer | no trial arm names this drug |
| Fatigue (tiredness) | 1,496 | 0.6 0.5–0.6ROR 0.5 · calibrated p 0.065 | 0.6 EB05 0.5 · IC025 -0.9 PRR-only: not supported by EBGM or IC | Not in label — unassessed | serious PRR 0.4 | no trial arm names this drug |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- International normalised ratio — n=46, PRR 114.2
- Haemorrhagic anaemia — n=1,245, PRR 112.7
- Strangulated hernia — n=24, PRR 33.8
- Heart transplant — n=85, PRR 30.3
- Haemorrhagic transformation stroke — n=141, PRR 30.0
- Brain midline shift — n=50, PRR 29.8
- Cardiac tamponade — n=413, PRR 27.5
- Incarcerated hernia — n=25, PRR 25.6
- Gastrointestinal arteriovenous malformation — n=23, PRR 24.4
- Coagulopathy — n=1,260, PRR 23.8
✓ A hand-written Bradford Hill causality assessment exists for this drug: Dabigatran ↔ Gastrointestinal bleeding.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Dabigatran Etexilate Mesylate?
In FDA FAERS, the most frequently co-reported reaction terms for Dabigatran Etexilate Mesylate are gastrointestinal haemorrhage, cerebrovascular accident, fall, haemorrhage, anaemia, ischaemic stroke. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Dabigatran Etexilate Mesylate have an FDA boxed warning?
Yes. The current FDA label carries a boxed warning: (A) PREMATURE DISCONTINUATION OF DABIGATRAN ETEXILATE CAPSULES INCREASES THE RISK OF THROMBOTIC EVENTS, and (B) SPINAL/EPIDURAL HEMATOMA (A) PREMATURE DISCONTINUATION OF DABIGATRAN ETEXILATE CAPSULES INCREASES THE RI.
Do FAERS signals prove that Dabigatran Etexilate Mesylate causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 13649035-a498-4e31-a7ea-8b18cedceca7, effective 20251120; matched on
openfda.generic_name.exact:"DABIGATRAN ETEXILATE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,230 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
DABIGATRAN ETEXILATE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.