Background: Dabigatran is a novel oral anticoagulant molecule which is a direct thrombin
(Factor IIa) inhibitor and is used for prevention of stroke and systemic embolism. It is easy to
administer as compared to warfarin therapy as it does not require routine laboratory monitoring and
has fewer drug interactions.
Objective: To present a rare case of oral ulcers secondary to dabigatran in a patient with deep vein
Case Report: A 68-year-old female presented with painful oral ulcers, retrosternal pain and difficulty
in swallowing. She had been taking capsule Dabigatran for the prevention of systemic embolism
for 2 months. She had experienced symptoms of onset taking dabigatran for 7 days. Clinical examination
revealed three tender, well-defined, clean looking ulcers of various sizes present over the
dorsum of the tongue. Dabigatran was withdrawn and the patient was on oral proton pump inhibitors.
Patient showed remarkable improvement in oral ulcers after 2 weeks.
Conclusion: Patient education and counseling should be done regarding this side effect of
dabigatran and proper intake of this medicine.