Name Prasugrel Hydrochloride
Classes Anticoagulant
Antihypertensive Combination
Antihypertensive
Diseases

Prasugrel Hydrochloride

Prasugrel HCl is an anticoagulant. Prasugrel HCl inhibits platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y12 class of ADP receptors on platelets. 

Prasugrel HCl is indicated in-

  • Unstable angina
  • Non ST-elevation Myocardial infarction
  • Patients with ST-elevation myocardial infarction (STEMI) when managed with either primary or delayed PCI
  • Initiate treatment with a single 60 mg oral loading dose
  • Continue at 10 mg once daily with or without food.  Consider 5 mg once daily for patients < 60 kg
  • Patients should also take aspirin (75 mg to 325 mg) daily 

Side effects of prasugrel include-

  • Bleeding, including life-threatening and fatal bleeding
  • Thrombotic thrombocytopenic purpura
  • Prasugrel HCl can cause significant, sometimes fatal, bleeding.
  • Do not use Prasugrel HCl in patients with active pathological bleeding or a history of transient ischemic attack or stroke.
  • In patients ≥ 75 years of age, Prasugrel HCl is generally not recommended, because of the increased risk of fatal and intracranial bleeding and uncertain benefit, except in high-risk situations (patients with diabetes or a history of prior MI) where its effect appears to be greater and its use may be considered.
  • Do not start Prasugrel HCl in patients likely to undergo urgent coronary artery bypass graft surgery (CABG).  When possible, discontinue Prasugrel HCl at least 7 days prior to any surgery. Additional risk factors for bleeding include:
    • body weight < 60 kg
    • propensity to bleed
    • concomitant use of medications that increase the risk of bleeding (e.g., warfarin, heparin, fibrinolytic therapy, chronic use of non-steroidal anti-inflammatory drugs [NSAIDS])
  • Suspect bleeding in any patient who is hypotensive and has recently undergone coronary angiography, percutaneous coronary intervention (PCI), CABG, or other surgical procedures in the setting of Prasugrel HCl. If possible, manage bleeding without discontinuing Prasugrel HCl.  Discontinuing Prasugrel HCl, particularly in the first few weeks after acute coronary syndrome, increases the risk of subsequent cardiovascular events.
  • Discontinuation of Prasugrel HCl: Premature discontinuation increases risk of stent thrombosis, MI, and death.
  • Thrombotic thrombocytopenic purpura (TTP): TTP has been reported with Prasugrel HCl.

Contraindication

Hypersensitivity to prasugrel or any component of the product.

Contraindicated in-

  • Bleeding
  • Prior myocardial infarction
  • Prior Stroke