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Prasugrel belongs to a group of medicines called antiplatelets or blood thinners. It helps prevent the formation of harmful blood clots and keeps the blood flowing smoothly through your body. This lowers the chances of another heart attack or stroke in people with heart disease. Prasugrel is used to treat people with a recent heart attack or severe heart-related chest pain (unstable angina), who have undergone stenting of the heart. It helps to prevent serious heart-related problems like having another heart attack, stroke, or formation of blood clots in stents. Your doctor will also prescribe aspirin, another antiplatelet medicine, along with it. This medicine may be taken with or without food and should be taken regularly at the same time each day. It is important to keep taking this medicine even if you feel well. If you stop taking this medicine, it may increase your chances of having another heart attack or stroke. The most common side effect seen with this medicine is bleeding. This may be in the form of bruising, nose bleeds, blood in urine or stools (black colored stools), or heavier periods than usual in women. If you cut or injure yourself, it may take longer than usual for the bleeding to stop. Such episodes of bleeding are usually mild and resolve on their own. However, you should consult your doctor straight away if the bleeding persists or worries you. This medicine is not suitable for some people. Do not take it if you are bleeding from anywhere in the body such as a stomach ulcer or bleeding within the brain, or if you have severe liver problems. Before taking it, you should let your doctor know if you have ever had a problem with your blood not clotting properly or if you have recently had a serious injury or surgery. This medicine may need to be stopped temporarily before planned surgery or dental treatment. Pregnant or breastfeeding women should also consult their doctor before taking it. Prasugrel is an antiplatelet medication. It works by preventing platelets from sticking together, thereby decreasing the formation of harmful blood clots. This lowers the chances of another heart attack or stroke.

• Prevention of heart attack and stroke • Heart attack

Prasugrel is a prodrug that inhibits platelet activation and aggregation. The active metabolite irreversibly blocks the P2Y12 component of adenosine diphosphate (ADP) receptors on the platelet, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet activation and aggregation.

Adult Dose: Oral Acute coronary syndrome Adult: 60 mg as loading dose, followed by 10 mg once daily for up to 12 mth, given in combination w/ aspirin. Elderly: >75 yr Maintenance: 5 mg once daily. Patient w/ low body wt (<60 kg): 5 mg once daily as maintenance dose. Hepatic impairment: Severe (Child-Pugh class C): Contraindicated. Renal Dose: Renal impairment Dose adjustment not necessary

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Prasugrel may be taken with or without food, but it is better to take it at a fixed time.

If you miss a dose of Prasugrel, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Bleeding

[SAFE] Prasugrel does not usually affect your ability to drive. For best results, take it at the same time every day. Prasugrel increases your risk of bleeding. Be careful while shaving, using sharp objects, or cutting fingernails or toenails. Do not discontinue using the medicine without consulting your doctor as this may increase your chances of having another heart attack or stroke. If you are scheduled to undergo a surgery or dental treatment, you may be asked to stop taking Prasugrel temporarily.

Active pathological bleeding such as peptic ulcer or intracranial hamorrhage. Patient with a history of prior transient ischemic attack or stroke

Increased risk of bleeding w/ oral anticoagulants (e.g. warfain), clopidogrel, NSAIDs and fibrinolytics.

[SAFE] Consuming alcohol with Prasugrel does not cause any harmful side effects.

[SAFE IF PRESCRIBED] Prasugrel is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.

[SAFE IF PRESCRIBED] Prasugrel is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[SAFE IF PRESCRIBED] Prasugrel is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Prasugrel may not be needed in these patients. Please consult your doctor. [CAUTION] Prasugrel should be used with caution in patients with severe liver disease. Dose adjustment of Prasugrel may be needed. Please consult your doctor. Limited information is available on the use of Prasugrel in these patients. No dose adjustment is recommended in patients with mild to moderate liver disease.

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