Prasugrel

• OP: 5 mg and 10 mg.

• Take orally, with or without food.
• Should be used with low-dose aspirin.
• Should not be used in patients likely to undergo urgent coronary artery bypass graft surgery due to bleeding risk.

Mechanism of Action:

• Prasugrel is a thienopyridine class antiplatelet agent.
• It irreversibly binds to P2Y12 ADP platelet receptors, preventing platelet activation and aggregation.

Pharmacokinetics:

• Absorption: Rapidly absorbed and metabolized to active metabolite.
• Onset: Within 30 minutes.
• Half-life: Active metabolite: ~7 hours.
• Metabolism: Hepatic, via CYP3A4 and CYP2B6.
• Elimination: Mainly renal and biliary.

Common:

• Bleeding (major and minor)
• Hypertension
• Headache
• Hyperlipidemia

Serious:

• Fatal bleeding
• Thrombocytopenia
• Hypersensitivity reactions (e.g., angioedema)

• Active pathological bleeding (e.g., peptic ulcer, intracranial hemorrhage)
• History of transient ischemic attack (TIA) or stroke
• Hypersensitivity to prasugrel or any component of the formulation

• Increased bleeding risk with:
• Other antiplatelet drugs (e.g., clopidogrel, ticagrelor)
• Anticoagulants (e.g., warfarin, DOACs)
• NSAIDs
• CYP3A inhibitors or inducers may affect prasugrel metabolism, but no dosage adjustment is typically required.