Plasma concentrations of dabigatran, an active principle of prodrug dabigatran etexilate (
DABE
), are increased by renal impairment (
RI
) or coadministration of a P‐glycoprotein inhibitor. Because the combined effects of drug–drug interactions and
RI
have not been evaluated by means of clinical studies, the decision of
DABE
dosing for
RI
patients receiving P‐glycoprotein inhibitors is empirical at its best. We conducted virtual
drug–drug interactions
studies between
DABE
and the P‐glycoprotein inhibitor verapamil in
RI
populations using physiologically based pharmacokinetic modeling. The developed
physiologically based pharmacokinetic
model for
DABE
and
dabigatran
was used to predict trough
dabigatran
concentrations in the presence and absence of verapamil in virtual
RI
populations. The population‐based
physiologically based pharmacokinetic
model provided the most appropriate dosing regimen of
DABE
for likely clinical scenarios, such as drug–drug interactions in this
RI
population based on available knowledge of the systems changes and in the absence of actual clinical studies.