Prasugrel

Cerebral Infarction, Myocardial Infarction ... show more

Drug Status

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Government Approvals

US(FDA), UK(BNF)

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WHO Essential Medicine

NO

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Known Teratogen

No

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Pharmaceutical Class

P2Y12 Platelet Inhibitor

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Controlled Drug Substance

No

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Drug Ingredient

Prasugrel

Summary

  • 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

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.

What is Prasugrel?

Prasugrel helps reduce the risk of heart or blood vessel problems like heart attacks, strokes, and blood clots in stents. It works by preventing platelets from clumping together and forming clots.

Directions for Use

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 do I dispose of Prasugrel?

If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.

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.

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.

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.

Warnings and Precautions

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 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.

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.

Does Prasugrel have adverse effects?

Adverse effects, which are unwanted or harmful reactions to a medicine, can occur with any medication. For this medicine, common adverse effects might include nausea, headache, dizziness, fatigue, and dry mouth. These effects can vary in how often they happen, but they are generally not severe. However, there are rare but serious adverse effects that need immediate medical attention, such as difficulty breathing, severe rash, or swelling of the face and throat. It's crucial to report any new or worsening symptoms to a healthcare provider. Never stop taking a medicine without first consulting with a healthcare professional, as they can provide guidance on how to manage side effects safely.

Does Prasugrel have any safety warnings?

To determine if a medicine has safety warnings, you should first check the prescription information provided with the medicine. This information often includes a section on warnings and precautions. For example, if a medicine has a warning about causing drowsiness, the rationale is that it can impair your ability to drive or operate machinery, leading to accidents. The possible consequence is injury to yourself or others. To guard against this, you should monitor for signs of drowsiness, such as feeling unusually sleepy or having difficulty concentrating. If you experience these symptoms, avoid activities that require full alertness. Always consult with a healthcare professional for personalized advice.

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.

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 stop Prasugrel?

To determine if it's safe to stop a medicine, first identify its purpose. If it's for managing a chronic condition like hypertension or diabetes, stopping it suddenly can lead to serious health risks, such as uncontrolled blood pressure or blood sugar levels. If the medicine is for symptomatic relief or treating an acute condition, like an infection, stopping it prematurely might result in the return of symptoms or incomplete treatment. Some medicines can cause withdrawal or rebound symptoms if stopped abruptly, which can be uncomfortable or even dangerous. It's crucial to consult with a doctor before stopping any medicine, as they can provide guidance on how to safely discontinue it, if appropriate, and monitor for any adverse effects.

Is Prasugrel addictive?

This medicine does not have any known potential for dependence or addiction. It is considered safe in terms of habit-forming properties. Therefore, there is no need to worry about physical or psychological dependence when using this medication as prescribed. However, it is always important to follow the dosage instructions provided by your healthcare provider to ensure safe and effective use. If you have any concerns or experience any unusual symptoms, it is advisable to consult with your healthcare professional for further guidance.

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.

What are the most common side effects of Prasugrel?

A side effect is an unwanted or unexpected symptom caused by a medicine. For this medicine, common side effects may include nausea, which is feeling sick to your stomach, dizziness, which is feeling lightheaded or unsteady, headache, which is pain in the head, fatigue, which is feeling very tired, and dry mouth, which is a lack of saliva. The frequency of these side effects can vary, but they are generally considered common. It's important to note that when starting a new medicine, people might experience new symptoms that could be coincidental, unrelated, or temporary. These symptoms might also be due to another health issue. Always talk to a healthcare provider before stopping any medicine, as they can provide guidance on managing side effects and ensure your treatment is safe and effective.

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.