| Atrial Fibrillation
Multaq vs Pradaxa
Side-by-side clinical, coverage, and cost comparison for atrial fibrillation.Deep comparison between: Multaq vs Pradaxa with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsPradaxa has a higher rate of injection site reactions vs Multaq based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Pradaxa but not Multaq, including UnitedHealthcare
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Category
Multaq
Pradaxa
At A Glance
Oral
Twice daily
Multi-class antiarrhythmic
Oral
Twice daily
Direct thrombin inhibitor
Indications
- Atrial Fibrillation
- Atrial Fibrillation
- Deep Vein Thrombosis
- Pulmonary Embolism
Dosing
Atrial Fibrillation 400 mg twice daily orally; one tablet with the morning meal and one tablet with the evening meal.
Atrial Fibrillation CrCl > 30 mL/min: 150 mg orally twice daily; CrCl 15-30 mL/min: 75 mg orally twice daily; reduce to 75 mg twice daily if CrCl 30-50 mL/min with concomitant dronedarone or systemic ketoconazole.
Deep Vein Thrombosis, Pulmonary Embolism Treatment: 150 mg orally twice daily after 5-10 days of parenteral anticoagulation (CrCl > 30 mL/min); recurrence reduction: 150 mg orally twice daily after previous treatment (CrCl > 30 mL/min).
Prophylaxis of DVT and PE Following Hip Replacement Surgery 110 mg orally on day 1 (1-4 hours after surgery and after hemostasis), then 220 mg once daily for 28-35 days (CrCl > 30 mL/min).
Pediatric VTE Weight-based dosage orally twice daily after at least 5 days of parenteral anticoagulant (ages 8 to <18 years); adjust dose per actual weight as treatment progresses.
Contraindications
- Permanent atrial fibrillation (patients in whom normal sinus rhythm will not or cannot be restored)
- Symptomatic heart failure with recent decompensation requiring hospitalization or NYHA Class IV symptoms
- Second or third-degree atrioventricular (AV) block, or sick sinus syndrome (except when used in conjunction with a functioning pacemaker)
- Bradycardia
- Concomitant use of strong CYP3A inhibitors (ketoconazole, itraconazole, voriconazole, cyclosporine, telithromycin, clarithromycin, nefazodone, ritonavir)
- Concomitant use of erythromycin
- Concomitant use of QT-prolonging drugs or herbal products (phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, Class I and III antiarrhythmics)
- Liver or lung toxicity related to previous use of amiodarone
- QTc interval >500 ms or PR interval >280 ms
- Severe hepatic impairment
- Hypersensitivity to the active substance or to any of the excipients
- Active pathological bleeding
- History of serious hypersensitivity reaction to dabigatran, dabigatran etexilate, or any excipient (e.g., anaphylactic reaction or anaphylactic shock)
- Mechanical prosthetic heart valve
Adverse Reactions
Most common (>=1%) Diarrhea, nausea, abdominal pain, vomiting, dyspepsia, asthenia, bradycardia, skin rash
Serious New or worsening heart failure, liver injury, pulmonary toxicity, QT prolongation, hypokalemia and hypomagnesemia with potassium-depleting diuretics
Postmarketing New or worsening heart failure, atrial flutter with 1:1 AV conduction, liver injury, interstitial lung disease (pneumonitis, pulmonary fibrosis), anaphylactic reactions including angioedema, vasculitis including leukocytoclastic vasculitis
Most common Bleeding events (major and minor), gastrointestinal adverse reactions (dyspepsia, nausea, vomiting, upper abdominal pain, diarrhea, gastritis-like symptoms)
Serious Intracranial hemorrhage, major gastrointestinal hemorrhage, anaphylactic reaction, anaphylactic shock
Postmarketing Agranulocytosis, neutropenia, thrombocytopenia, esophageal ulcer, angioedema, anticoagulant-related nephropathy, alopecia
Pharmacology
Dronedarone is an antiarrhythmic agent with properties belonging to all four Vaughan-Williams classes (I, II, III, and IV), though the mechanism of action and contribution of each class to the clinical effect is unknown; it also acts as a moderate inhibitor of CYP3A and CYP2D6 and inhibits P-glycoprotein transport.
Dabigatran and its acyl glucuronides are competitive, direct thrombin inhibitors that prevent thrombus formation by blocking thrombin-mediated conversion of fibrinogen to fibrin and inhibiting thrombin-induced platelet aggregation, acting on both free and clot-bound thrombin.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Multaq
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (0/12) · Qty limit (12/12)
Pradaxa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Multaq
- Covered on 4 commercial plans
- PA (6/8) · Step Therapy (0/8) · Qty limit (3/8)
Pradaxa
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (1/8) · Qty limit (1/8)
Humana
Multaq
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (2/3)
Pradaxa
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Multaq.
No savings programs available for Pradaxa.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.