For the last 60 years warfarin has been the cornerstone for chronic 
anticoagulation in prevention of ischemic strokes and systemic embolization. 
Warfarin therapy has several limitations including frequent monitoring and 
various food and significant drug interactions, which make it a less than ideal 
chronic oral anticoagulant. The continued search for safe, effective, 
medications with predictable pharmacokinetic profiles has led to newer 
alternatives. Dabigatran is a potent reversible, competitive direct thrombin 
inhibitor which is available as the prodrug, Dabigatran etexilate. It was first 
approved in Europe and recently in October 2010, the US food and drug 
administration (FDA) has approved the use of this novel oral anticoagulation for 
prevention of stroke in those with non valvular atrial fibrillation. This review 
will cover the chemical structure, mechanism of action, pharmacokinetic profile, 
clinical trials, dosage, clinical implication and adverse effects of dabigatran.