Uses of undefined

Prasugrel is indicated for reducing thrombotic cardiovascular events, including stent thrombosis, in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). It is suitable for patients with unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). 

Prasugrel has been shown to lower the rates of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke compared to clopidogrel. Proper treatment is important, especially in emergency cases, while balancing bleeding risks in patients needing Coronary artery bypass grafting.

undefined Drug administaration and Dosage available

Start treatment with prasugrel using a single 60 mg oral loading dose, followed by a maintenance dose of 10 mg daily. Patients should also take aspirin daily at a dose of 75 mg to 325 mg. Prasugrel can be administered with or without food.

For patients weighing less than 60 kg, the 10 mg daily maintenance dose may result in increased exposure to the active metabolite and a higher risk of bleeding. Consider reducing the maintenance dose to 5 mg for these patients; however, the effectiveness and safety of this 5 mg dose have not been prospectively evaluated.

Warnings, Precautions and Side Effects of undefined

Warnings

• Risk of bleeding: Prasugrel increases the risk of bleeding.Watch for any symptoms of major or minor bleeding, particularly if you’ve recently had procedures like coronary angiography or PCI. Seek medical attention if you experience unusual bruising or bleeding.
• Older adults: The use of prasugrel is generally not recommended for patients aged 75 years or older due to a higher risk of bleeding and uncertain effectiveness unless they are in high-risk situations.
• Surgical procedures: Prasugrel should be discontinued at least 7 days before any planned CABG or other surgical procedures to reduce the risk of excessive bleeding.
• Thrombotic thrombocytopenic purpura (TTP): TTP, a serious condition that can be fatal, has been reported with prasugrel use. Watch for symptoms such as low platelet counts, anaemia, and neurological changes, and seek urgent medical care if they occur.
• Weight considerations: For patients weighing less than 60 kg, consider a lower maintenance dose due to increased bleeding risk. Regular monitoring may be necessary.

Precautions

Before starting prasugrel, consider these important precautions. Avoid using this medication if you have active bleeding, a history of stroke, or TIA. Discuss any previous bleeding issues with your healthcare provider. If you have kidney or liver problems, inform your doctor, as they may need to monitor your condition closely. 

Be aware that prasugrel can cause gastrointestinal issues; maintain proper hydration and report any severe symptoms. Provide your healthcare provider with a complete list of all medications you are taking to avoid potential interactions, particularly with medicines that increase bleeding risk. Regular follow-ups are required to make sure the therapy is effective and to manage any side effects.

Side Effects

Common side effects 

• Bleeding
• Bruising
• Nausea
• Abdominal pain
• Dizziness
• Headache
• Rash or itching

Serious side effects 

• Thrombotic thrombocytopenic purpura (TTP)
• Significant bleeding events
• Allergic reactions
• Severe gastrointestinal bleeding

Word Of Advice

Inform your doctor if you have a history of kidney or liver issues, as they may require close monitoring during treatment. Regularly check for gastrointestinal symptoms and stay hydrated to prevent dehydration. Report any skin reactions or symptoms of low blood cell counts to your healthcare provider immediately. Always disclose all other medications you are taking to avoid potential interactions. Use prasugrel during pregnancy only when necessary and monitor for allergic reactions; report any concerns without delay.

Frequently Asked Question

• Is prasugrel a blood thinner or an antiplatelet?
• Prasugrel is classified as an antiplatelet medication. It works by inhibiting platelet aggregation, which helps prevent the formation of blood clots. This makes it particularly useful in managing patients who have undergone procedures like angioplasty or who have acute coronary syndrome.

• When is the best time to take prasugrel?
• The best time to take prasugrel is usually once daily, with or without food. It’s important to follow your healthcare provider's instructions regarding the timing and dosage specific to your situation.

• Is prasugrel the same as clopidogrel?
• No, prasugrel is not the same as clopidogrel. Both are antiplatelet medications, but they have different active ingredients, mechanisms of action, and dosing requirements. Prasugrel is often more potent but may have different safety profiles compared to clopidogrel.