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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).

Indications
  • Unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI)
  • ST-elevation myocardial infarction (STEMI) managed with primary or delayed PCI
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.

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
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
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.

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
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.

Prasugrel — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.