Atrial fibrillation is a type of irregular heartbeat that can cause blood clots, heart attacks and strokes. For years, doctors have prescribed blood-thinners like Coumadin, also known as warfarin, to those who suffer from atrial fibrillation. The blood thinners prevent the clots from forming, and so prevent the heart attacks and strokes.

A few years ago a new drug came on the market, Pradaxa. Manufactured and marketed by Boehringer Ingelheim, a German company, Pradaxa has been a huge money maker, accounting for $1 billion in sales in 2011 alone.

Like Coumadin or warfarin, Pradaxa works to prevent strokes and heart attacks, though at least one study found that Pradaxa isn’t as good as Coumadin. Only problem is that if someone taking the drug starts to bleed, the bleeding can’t be stopped. Unlike warfarin or Coumadin, there is no antidote (called “reversing agent”) to stop the drug’s blood-thinning effects. A patient who cuts himself or, perhaps falls and begins to bleed internally, may get himself to the hospital, but there often is nothing the doctors can do except make the patient comfortable as he bleeds to death in the ER. 

Pradaxa supporters agree that an antidote would be “desirable.” But as one researcher noted, “when prescribing a drug with side effects that include life–threatening hemorrhage, reversal is not ‘desirable,’ it is essential.”

  • Generic name: dabigatran
  • Manufacturer: Boehringer Ingelheim
  • Sales: Approximately $1 Billion per year
  • Side Effect: Fatal Hemorrhage