Recent oral direct thrombin inhibitor which can be used for the prevention of stroke is:

Ximelagatran was the first oral direct thrombin inhibitor approved; however, it was later withdrawn because of hepatotoxicity. Recently a new direct thrombin inhibitor dabigatran has been approved for the prophylaxis of stroke and systemic embolism in nonvalvular atrial fibrillation. It is administered as a prodrug; dabigatran etexilate. It is not metabolized by CYP enzymes however dose adjustment is required in renal failure.