This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Anticoagulants and Coagulants, Subject name: Pharmacology
Recent oral direct thrombin inhibitor which can be used for prevention of stroke is: 
Select and explain. 
A. Dabigatran, B. Ximelagatran, C. Lepirudin, D. Saxagliptin
A: Dabigatran
Answer: A: Dabigatran 
Explanation: Ans. (A) Dabigatran:(Ref: Katzung 11/e p594, CMDT 2012/537, KDT 8/e p671,672)Ximelagatran was the first oral direct thrombin inhibitor approved; however it was later withdrawn because of hepatotoxicity.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.