前言:新型口服抗凝血藥dabigatran(Pradaxa®)用於預防非瓣膜性心房纖維顫動導致中 風，與傳統抗凝血劑warfarin比較，dabigatran優點為使用方便(固定劑量），不需定期驗 血監測及較少的藥物交互作用6，但使用限制為嚴重腎功能不全或肝功能異常及高出血 風險者5。另外dabigatran價格較昂貴，健保藥費約3000元/人/月。目的:本次藥物使用 評估旨在了解dabigatran在本院使用是否合乎治療準則、有效性及安全性。方法：回溯 性病歷回顧蒐集本院使用dabigatran預防心房纖維顫動導致中風的病人。評估項目： CHA2DS2-VASc分數、禁忌症、嚴重藥物交互作用、藥物不良反應等。結果：2014-2015 年使用dabigatran的病人共65人。CHA2DS2-VASc分數22分符合治療準則達100°%。病 人曾經中風有69°%。劑量不足9°%，使用禁忌17°%，嚴重交互作用12°%。藥物不良反應 14%。結語:本次用藥評估發現醫師較易疏忽潛在的用藥安全，除了宣導提醒醫師注意， 同時加強藥品資訊提示功能，以達到預防中風且降低藥物不良反應發生。

Background: The Novel Oral AntiCoagulants (NOAC) dabigatran (Pradaxa®) is used to prevent non-valvular atrial fibrillation (NVAF) from stroke.Compared with warfarin, dabigatran has the advantage of being convenient (fixed dose), without periodic blood test and less drug interaction. 6 However, if the patient has severe renal insufficiency or abnormal liver function and high bleeding risk for the use of restrictions 5. In addition dabigatran price is more expensive, health insurance drugs about NT3,000 / person / month.Objective:This study aimed to understand the use of dabigatran in the hospital is in compliance with treatment guidelines, effectiveness and safety. Methods: A retrospective chart review was performed on patients who use dabigatran to prevent non-valvular atrial fibrillation (NVAF) from stroke. Evaluation items: CHA2DS2-VASc scores, contraindications, major drug interactions, adverse drug reactions etc. Results: Between January 2015 and December 2016, out of 65 patients who use dabigatran to prevent non-valvular atrial fibrillation (NVAF) from stroke. CHA2DS2-VASc score >2 points meet the treatment criteria of 100%. Had a stroke of 69%. Safety assessment: less than the recommended dose 9%, the use of contraindications 17%, major drug interactions 12%,adverse drug reactions 14%.Conclusion: Through this medication use evaluation to understand the physicians more easily ignored potential drug safety. In addition to advocacy to remind physicians attention, while strengthening the drug information tips to achieve the prevention of stroke and reduce adverse drug reactions occur.