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Dynamic Chiropractic – August 26, 2012, Vol. 30, Issue 18

Side Effects From Big Pharma: Pradaxa (Dabigatran Etexilate) – A Case Study

By Shawn Steel, JD

Long ago, D.D. Palmer differentiated chiropractic from medicine by abstaining from the use of drugs. For hundreds of years, health care practitioners were acutely aware of the drawbacks and side effects of medication usage.

Despite daily stories about glaring misfortunes of pharmacology, most Americans in their 60s are on drugs. This is not merely a result of the laid-back 1960s; each succeeding generation is taking and depending on greater drug usage for a combination of perceived ailments.

The question is, do patients know what they are taking and why? Looking at those long lines at the local pharmacy, you have to wonder if patients are aware that taking medications can be very risky. Merely mixing the wrong drugs can create a nightmare. Of course, many drugs are potentially lifesaving, but even a "good" drug still can have catastrophic results.

Most compelling is the clear contradiction within the pharmaceutical industry. Thousands of scientists work around the clock to find solutions toward saving lives; yet Big Pharma is also among the most successful businesses worldwide. Health care consumes more than 15 percent of our GNP.1 That makes Big Pharma one of the world's largest and most profitable businesses. Its power is felt in all state legislatures and in Washington. And it has been suggested that Big Pharma not only had a major role writing ObamaCare – and vastly protecting its interests to the tune of endless billions – but also spent hundreds of millions of advertising dollars supporting it.2

Big Pharma will play both sides. It produces drugs that save lives, but also calculates the cost of side effects when considering the bottom line. Big Pharma knows it produces a lot of drugs that hurt people. It knows it will get sued and prepares litigation strategies for the release of each new drug.

An interesting tale begins with Pradaxa, a newcomer drug introduced in October 2010 as a blood thinner for patients with a high risk of stroke and/or blood clots. The company that produces Pradaxa is Austria-based Boehringer Ingelheim Pharmaceuticals. Presently, Boehringer Pharma does disclose a number of side effects on its Web site,3 and apparently for good reason: In a short period of time, side effects from Pradaxa use has led to a large number of lawsuits.

Attorneys for victims argue that Pradaxa carries a significant risk for poor side effects than Pradaxa advertises. Plaintiffs claim that the main risk is internal bleeding problems; and that Boehringer Pharma did not properly test and research or provide fair notice of serious side effects before marketing its product.

In January 2012, the Journal of Neurosurgery reported that Pradaxa side effects can lead to death. The article cited the case of an 83-year-old man who used Pradaxa for four weeks and got sick. At the hospital, he fell into a coma and subsequently died due to a brain hemorrhage. The article stated that "as use of this drug becomes more widespread, more intracranial hemorrhage resulting from even minor trauma may occur with increased frequency."

Clearly this is a major alarm coming from a leading publication. Medical doctors are now warned that continued use of Pradaxa has significant risks for patients who are 75 years old or older, who may have kidney or stomach problems, and/or who are taking aspirin- like products.

According to the Institute for Safe Medication Practices (who knew such a group existed?), of approximately 900 reported cases of Pradaxa-related side effects, 500 were serious enough to require hospitalization. From that group, 120 people died and 25 suffered permanent disabilities.4

Chiropractors have known since the inception of the profession that taking drugs can be risky. With the explosion of "drug therapies," the dangers will continue to grow geometrically. But what can and should a chiropractor do with their patients?

Chiropractors are not trained to give pharmaceutical advice. They do not prescribe. However, as a licensed primary health care provider, chiropractors ought to be aware of their patient's pre-existing history. Without accurate knowledge of the patient's "medical" issues, an accurate diagnosis is difficult.

Ask the patient what drugs they are currently taking and ask why. If you have concerns about your patient's drug usage, you may want to call the patient's medical doctor or refer the patient to a medical doctor you trust for a second opinion. Either way, you are looking out for your patient by helping them become more aware that the drugs they are taking may come with a hidden cost.


  1. Health Care Spending as a Percentage of Gross National Product, United States.
  2. "ObamaCare's Secret History: How a Pfizer CEO and Big Pharma Colluded With the White House at the Public's Expense." The Wall Street Journal, June 11, 2012.
  3. Pradaxa (dabigatran etexilate): Safety and Side Effects. Boehringer Ingelheim Pharmaceuticals.
  4. Institute for Safe Medication Practices: Safety Signals & Red Flags for Pradaxa.

Shawn Steel created a new field of law by defending chiropractors and acupuncturists, and representing their patients in personal-injury matters. He has law offices in San Francisco, Los Angeles and Orange County, Calif.; has taught ethics and jurisprudence classes at Cleveland Chiropractic College since 1991; and is a prolific lecturer and writer with more than 40 articles and book chapters to his credit.

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