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Treatment with dabigatran etexilate is contraindicated in acute hemorrhage pradaxa value, severe renal impairment (creatinine clearance below 30 ml / minute), impaired liver function, and concomitant use of quinidine, ketoconazole, itraconazole cyclosporine, tacrolimus. [7] Because of the potential for critical adverse reactions in individuals with renal failure is before the start of therapy in every single situation, a determination of creatinine clearance is vital, thus, the renal function for the duration of therapy adequately managed.