Perils of Pradaxa (Dabigatran) for People with Chronic Pain and Chronic Lower Back Disc Degeneration

I received this message  today from a physician who wishes to remain anonymous or at least have a reduced 'Internet footprint'

Mardy, Please share this information with people on Lumigrate. People with chronic pain should use Pradaxa only in very extenuating circumstances.

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  IMPORTANT Clinical information for anyone suffering chronic pain, fibromyalgia etc:
  
  Got pain? Beware of Pradaxa. This report raises very important clinical management issues and thus caution is needed in any group of patients who are at high risk for falling. Two such groups that are generally unappreciated by the medical community are:
  
  1. Chronic pain sufferers. Pain itself is a risk factor for falling and those who suffer falls have randomly distributed injuries including trauma to the head and face. Normal protective reflexes do not seem to play a role in preventing head injury (not necessarily brain injury) in these patients. These falls affect people with pain regardless of age and chronic pain is generally a disease of people in their 30s and 40s.
  
  2. People with chronic lower back disc degeneration may be at particular risk for falls. For instance the "vacuum disc", a radiologic sign of advanced disc degeneration, is most likely a risk factor for sudden uncontrolled falls. 
  
  Pradaxa should be prescribed with great caution in these sub-populations.

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  Medical News:Minor Trauma Led to Death in Pradaxa Patient - in Neurology, Head Trauma from MedPage T

  www.medpagetoday.com

  A dabigatran (Pradaxa) patient's death from a brain hemorrhage following a fall has again highlighted concerns over lack of an effective reversal agent for the drug.