melagatran + ximelagatran

This drug is a **combination of melagatran and ximelagatran**, developed for anticoagulation. Ximelagatran is an oral prodrug that is rapidly converted in vivo to the active compound, melagatran. Melagatran is a direct, competitive, and reversible inhibitor of both free and clot-bound **thrombin** by binding its active site, thereby inhibiting platelet activation and aggregation, and reducing fibrinolysis time. The combination was designed to be used for the **prevention and treatment of venous thromboembolism (VTE)**, especially in patients undergoing major orthopedic surgery (e.g., hip or knee replacement). It has also been studied for **stroke prevention in non-valvular atrial fibrillation, acute therapy and secondary prevention of deep vein thrombosis (DVT), and for prevention of recurrent ischemia following acute coronary syndrome**. The drug offered the advantage of rapid onset, oral dosing without the need for regular anticoagulant monitoring and with few drug interactions. However, **hepatotoxicity** led to its market withdrawal and discontinuation of further development[1][2][3][4].

Other names

melagatran/ximelagatran