Generic
Prasugrel
23 brands available in the market
At a glance
Prasugrel is an antiplatelet medication used to reduce thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndrome (ACS) who are to be managed with percutaneous coronary intervention (PCI).
Description
Prasugrel is a thienopyridine and a prodrug that irreversibly inhibits ADP receptors by acting on the P2Y12 receptor on platelets. The active metabolite prevents ADP from binding to its platelet receptor, impairing ADP-mediated activation of the GPIIb/IIIa complex, thereby reducing platelet activation and aggregation.
Indications
- Unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI)
- ST-elevation myocardial infarction (STEMI) managed with primary or delayed PCI
Therapeutic class
Anti-platelet drugs
Pharmacological class
P2Y12 Platelet Inhibitor (Thienopyridine)
Pharmacology
Prasugrel is a prodrug that irreversibly binds to the P2Y12 receptor on platelets, inhibiting ADP-mediated platelet activation and aggregation. The active metabolite prevents activation of the GPIIb/IIIa complex, reducing platelet aggregation and preventing thrombosis.
Mechanism of action
Prevents platelet aggregation and thrombosis by blocking platelet P2Y12 receptors.
Dosage
Adult Dose (Oral):
- Loading dose: 60 mg (single dose)
- Maintenance: 10 mg once daily (up to 12 months), with aspirin
- Elderly (≥75 years): 5 mg once daily (after 60 mg loading dose)
- Body weight <60 kg: 5 mg once daily (10 mg not recommended)
- Severe hepatic impairment (Child-Pugh class C): Contraindicated
Administration
- May be taken with or without food
- Take at the same time each day
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Bleeding (bruising, nosebleeds, blood in urine/stool, heavy menstrual bleeding)
- Anemia
- Hematoma
- Gastrointestinal hemorrhage
- Rash
- Ecchymosis
- Hematuria
- Vessel puncture site hematoma/hemorrhage
Precautions & warnings
- Bleeding risk: Caution; discontinue at least 7 days before surgery
- History of stroke or TIA: Contraindicated
- Active pathological bleeding: Contraindicated
- Severe hepatic impairment: Contraindicated
- Caution in pregnancy and lactation
Contraindications
- Active pathological bleeding (peptic ulcer, intracranial hemorrhage)
- History of prior transient ischemic attack (TIA) or stroke
- Severe hepatic impairment (Child-Pugh class C)
- Hypersensitivity to prasugrel or any ingredient
Drug interactions
- Oral anticoagulants (warfarin), clopidogrel, NSAIDs, fibrinolytics: Increased risk of bleeding
Food interactions
Alcohol consumption with Prasugrel does not cause harmful side effects.
Use in pregnancy
Use in Pregnancy: Generally considered safe; animal studies have shown low or no adverse effects; limited human studies available.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk to the baby.
Pediatric use
Not recommended for children below 18 years (lack of safety and efficacy data).
Geriatric use
Use in patients ≥75 years generally not recommended; if needed, 5 mg maintenance dose.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment required; consult your doctor.
Hepatic Impairment: No dose adjustment in mild-moderate hepatic impairment; contraindicated in severe hepatic impairment; consult your doctor.
Overdose effects
Overdose may lead to prolonged bleeding time and bleeding complications; treatment: platelet transfusion and/or other blood products may be considered.
Storage conditions
Store in a cool and dry place, protected from light and heat; keep out of reach of children.
Chemical structure
Prasugrel