Prasugrel
EFFIENT
What it isIrreversible P2Y12 antagonist; acute coronary syndrome managed with PCI.
Why this onePlatelet inhibition is stronger and more consistent than with clopidogrel and does not depend on CYP2C19 phenotype.
What limits itPrior stroke or TIA is an absolute contraindication; advanced age, low body weight, and surgery magnify bleeding risk.
FDA-approved for
- acute coronary syndrome (2009)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Bleeding risk (significant, sometimes fatal). Do not use with active bleeding or history of TIA/stroke. Generally not recommended ≥75 yr. Do not start if urgent CABG likely; d/c ≥7 days before surgery
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute coronary syndrome managed with PCI (reduce thrombotic CV events) | Adults | 60 mg loading dose | 10 mg QD | 10 mg QD |
Renal Undefined
Hepatic Undefined
Instructions
- Take with or without food
- Co-administer aspirin 75–325 mg daily
- Discontinue ≥7 days before surgery when possible
Contraindications
- Active pathological bleeding
- Prior transient ischemic attack or stroke
Cautions
- CABG-related bleeding
- Premature discontinuation → stent thrombosis, MI, death
- Thrombotic thrombocytopenic purpura (TTP)
- Hypersensitivity including angioedema
Adverse reactions
- Bleeding, including life-threatening and fatal bleeding
Pregnancy No human data; weigh bleeding risk to fetus
Lactation Undefined
⚠ BOXED WARNING
- Bleeding risk; contraindicated after stroke or TIA
Cost, est. cash$4–$300/month
Generic entry2017
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityGI or intracranial bleeding, especially with anticoagulants, NSAIDs or serotonergic antidepressants.
Mechanism of action: Prasugrel ballicule
Open Prasugrel in the interactive console ↗
Memory aids: mascots and interaction avatars
Blue platelet grilled