Prasugrel
Cerebral Infarction, Myocardial Infarction ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
P2Y12 Platelet Inhibitor
Controlled Drug Substance
NO
Prasugrel
Learn more about this medicine -
Click HereSummary
Prasugrel is primarily used to prevent blood clots in patients with acute coronary syndrome, especially those undergoing procedures like stent placement. It's used in combination with aspirin to reduce the risk of heart attacks, strokes, and other cardiovascular complications.
Prasugrel works by inhibiting platelet aggregation, meaning it prevents blood platelets from clumping together to form clots. It blocks a specific receptor on platelets, reducing their activation and aggregation, and thus preventing blood clot formation.
The usual dose for adults is 10 mg once daily after an initial 60 mg loading dose. For patients with low body weight or over 75 years old, the dose may be reduced to 5 mg daily. Prasugrel can be taken with or without food, and should be swallowed whole.
The most common side effects of Prasugrel include bleeding, bruising, and nosebleeds. Other less frequent side effects may include dizziness, headache, rash, or gastrointestinal symptoms such as nausea. Serious adverse effects include severe bleeding events and low platelet count.
Prasugrel is not recommended for individuals with active bleeding disorders, a history of intracranial hemorrhage, or severe liver impairment. It should be used with caution in people with a history of gastrointestinal bleeding or stroke. It's also not recommended during breastfeeding and should be used only if clearly needed during pregnancy.
Indications and Purpose
What is Prasugrel used for?
Prasugrel is primarily indicated for the prevention of blood clots in patients with acute coronary syndrome (ACS), specifically those undergoing percutaneous coronary intervention (PCI), including stent placement. It is used in combination with aspirin to reduce the risk of thrombotic events like heart attacks, strokes, and other cardiovascular complications in these patients.
How does Prasugrel work?
Prasugrel is an antiplatelet medication that works by inhibiting platelet aggregation. It irreversibly blocks the P2Y12 receptor on platelets, preventing adenosine diphosphate (ADP) from activating platelets. This inhibition reduces platelet activation and aggregation, thereby preventing the formation of blood clots. By reducing clot formation, Prasugrel helps to lower the risk of heart attacks, strokes, and other thrombotic events in patients with acute coronary syndrome.
Is Prasugrel effective?
Prasugrel has been proven effective through clinical studies, particularly in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). The TRITON-TIMI 38 trial showed that prasugrel significantly reduced the risk of cardiovascular events (like heart attacks, stent thrombosis, and death from cardiovascular causes) compared to clopidogrel. Its faster and more potent platelet inhibition contributed to these outcomes, particularly in high-risk patients.
How does one know if Prasugrel is working?
The benefit of Prasugrel is primarily evaluated through clinical trials and patient outcomes. Key metrics include the reduction in the risk of major cardiovascular events such as heart attack, stroke, and death from cardiovascular causes, particularly in patients with acute coronary syndrome (ACS). Additionally, platelet inhibition is monitored to assess the drug's effectiveness in preventing thrombus formation, often measured by platelet function tests. Regular follow-up visits help track patient progress and any side effects.
Directions for Use
What is the usual dose of Prasugrel?
This medication is taken by mouth. The first dose is 60 mg, and then you take 10 mg once a day after that. There is no information about how much children should take.
How do I take Prasugrel?
Prasugrel can be taken with or without food. There are no specific food restrictions while taking this medication. However, it is important to swallow the tablet whole, without crushing or chewing it. If you have difficulty swallowing pills, consult your doctor for alternative options. Always take the medication as prescribed and follow the doctor's instructions.
For how long do I take Prasugrel?
The typical duration of prasugrel treatment is generally 6 to 12 months for patients with acute coronary syndromes undergoing percutaneous coronary intervention. Some studies indicate that treatment may extend up to 14.5 months or longer, depending on individual patient circumstances. It's essential for patients to consult their healthcare provider to determine the appropriate duration based on their specific health needs and risks.
How long does it take for Prasugrel to start working?
Prasugrel typically starts working within 30 minutes to 1 hour after ingestion, with its full effects usually seen within a few hours. This rapid onset helps in reducing the risk of blood clot formation, particularly in patients undergoing procedures like angioplasty or those with acute coronary syndrome. However, its maximum effect may take a few days of regular use.
How should I store Prasugrel?
Store the Prasugrel at normal room temperature, between 59°F to 86°F (15°C to 30°C). Keep the Prasugrel in their original container, with the lid tightly closed. The container includes a drying agent to absorb moisture, so don't remove it.
Warnings and Precautions
Who should avoid taking Prasugrel?
Prasugrel is contraindicated in individuals with active bleeding disorders, a history of intracranial hemorrhage, or severe hepatic impairment. It should be used with caution in people with a history of gastrointestinal bleeding, stroke, or those undergoing surgery. Warnings include an increased risk of bleeding, including fatal bleeding, and the need for careful monitoring during treatment, particularly in elderly patients and those with low body weight.
Can I take Prasugrel with other prescription drugs?
Prasugrel can interact with medications that increase bleeding risk, including anticoagulants (warfarin, heparin), antiplatelet drugs (aspirin, clopidogrel), and NSAIDs, which may heighten bleeding risks. Proton pump inhibitors (e.g., omeprazole) may reduce prasugrel’s effectiveness. Always consult a healthcare provider before using prasugrel with other drugs to avoid harmful interactions.
Can I take Prasugrel with vitamins or supplements?
Prasugrel can interact with certain vitamins and supplements, particularly those that affect blood clotting. Vitamin E, fish oil, and other omega-3 fatty acids, which have blood-thinning effects, may increase the risk of bleeding when used with Prasugrel. It's important to inform a healthcare provider about any supplements being taken to adjust treatment appropriately and minimize risks.
Can Prasugrel be taken safely while pregnant?
Prasugrel is classified as Pregnancy Category B by the FDA, meaning that it is not expected to harm an unborn baby based on animal studies. However, there are no well-controlled studies in pregnant women, so it should be used only if clearly needed. It is recommended to consult a healthcare provider before using prasugrel during pregnancy.
Can Prasugrel be taken safely while breastfeeding?
Prasugrel is not recommended for use during breastfeeding, as it is not known whether it passes into breast milk. Given the potential for serious side effects, such as bleeding, it is advised to consult a healthcare provider before using prasugrel while breastfeeding. Alternative treatments may be considered to avoid potential risks to the infant.
Is Prasugrel safe for the elderly?
Prasugrel is a medication used to prevent blood clots. It's usually not given to people who are 75 or older because it can make them more likely to bleed, sometimes seriously or even fatally. This is more common with prasugrel than with a similar medication called clopidogrel. However, people who are 75 or older may still be given prasugrel if they have certain conditions, like diabetes or a previous heart attack. In these cases, the benefits of the medication may outweigh the risks. It's important to note that the risk of bleeding increases with age, but the risk of bleeding with prasugrel compared to clopidogrel is about the same for people of all ages.
Is it safe to exercise while taking Prasugrel?
Exercise is fine, but avoid high-risk activities since this medicine increases bleeding risks. Follow your doctor’s guidance.
Is it safe to drink alcohol while taking Prasugrel?
Alcohol increases the risk of bleeding or stomach problems, so it’s best to avoid it with this medicine.
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