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Prasugrel
From WikEM
Contents
Administration
- Type: Antiplatelet
- Dosage Forms: 5, 10 mg
- Routes of Administration: Oral
- Common Trade Names: Effient
Adult Dosing
10 mg PO qd
- Start: 60 mg PO x1
- For patients undergoing PCI, give w/ aspirin 75-325 mg PO qd
- Consider decrease to 5 mg PO qd if < 60 kg
Pediatric Dosing
N/A
Special Populations
- Pregnancy Rating: B; No known risk of fetal harm based on animal data at up to 30x MRHD
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult: No adjustment
- Pediatric: N/A
Hepatic Dosing
- Adult: No adjustment for mild impairment. Not defined for severe impairment.
- Pediatric: N/A
Contraindications
- Allergy to class/drug
- Hypersensitivity to drug/class/compon.
- Active bleeding
- Stroke or TIA
- CABG within 7 days
Adverse Reactions
Serious
- Severe bleeding
- Hemorrhage
- TTP
- Thrombocytopenia
- Anemia
- Leukopenia
- Hepatic impairment
- Atrial fibrillation
Common
- Bleeding
- Hypertension
- Hyperlipidemia
- Headache
- Back pain
- Dyspnea
- Nausea
- Dizziness
- Cough
- Hypotension
- Fatigue
- Chest pain
- Atrial fibrillation
- Bradycardia
- Leukopenia
- Rash
- Fever
- Peripheral edema
- Extremity pain
- Diarrhea
Pharmacology
- Half-life: 7 hr
- Metabolism: Liver; CYP450: 2B6, 2C9/19 (minor), 3A4 substrate
- Excretion: Urine 68%, feces 27%
Mechanism of Action
Irreversibly binds to P2Y12 adenosine diphosphate receptors, reducing platelet activation and aggregation.
