Q: Effects of Dabigatran (an oral Direct Thrombin Inhibitor) may get accentuated (increase) with all of the following drugs except?

A) quinidine, 
B) verapamil, 
C) amiodarone,
D) Proton Pump Inhibitors (PPI)



Answer: D

Absorption of Dabigatran may be moderately decreased if taken with a proton pump inhibitor. Drug excretion through P-glycoprotein pumps is slowed in patients taking strong p-glycoprotein pump inhibitors such as quinidine, verapamil, and amiodarone, thus raising plasma levels of dabigatran.