Prasugrel

DEA Class; Rx

Common Brand Names; Effient

• Antiplatelet Agents, Cardiovascular; 
• Antiplatelet Agents, Hematologic

Hypersensitivity

Active pathologic bleeding (eg, peptic ulcer, intracranial hemorrhage)

Prior TIA or stroke

• Hypertension (7.5%)
• Hypercholesterolemia/hyperlipidemia (7%)
• Headache (5.5%)
• Back pain (5%)
• Dyspnea (4.9%)
• Nausea (4.6%)
• Dizziness (4.1%)
• Cough (3.9%)
• Hypotension (3.9%)
• Fatigue (3.7%)
• Noncardiac chest pain (3.1%)
• Atrial fibrillation (2.9%)
• Bradycardia (2.9%)
• Leukopenia (<4 x 10^9 WBC/L) (2.8%)
• Rash (2.8%)
• Pyrexia (2.7%)
• Peripheral edema (2.7%)
• Pain in extremity (2.6%)
• Diarrhea (2.3%)
• Thrombotic thrombocytopenic purpura
• Abnormal hepatic function
• Angioedema
• Hematoma
• Hemolysis
• Hemorrhage
• Abnormal liver function

Hypersensitivity with angioedema reported

Bleeding diathesis

Thrombocytopenic purpura occurring within 2 weeks of initiation of therapy reported

Discontinue treatment for active bleeding, elective surgery, stroke, or TIA; premature discontinuation of any antiplatelet medication conveys an increased risk of stent thrombosis, myocardial infarction, and death; patients who require premature discontinuation of a thienopyridine will be at increased risk for cardiac events; avoid lapses in therapy, and if thienopyridines must be temporarily discontinued because of an adverse event(s), restart as soon as possible

Risk increases in patients receiving drug who undergo CABG

Premature discontinuation increases risk of stent thrombosis, MI, and death

See Black Box Warnings

There are no data with prasugrel use in pregnant women to inform a drug-associated risk

Due to the mechanism of action, and the associated identified risk of bleeding, consider the benefits and possible risks to the fetus when prescribing prasugrel to a pregnant woman

There is no information regarding the presence of prasugrel in human milk, the effects on the breastfed infant, or the effects on milk production