Prasugrel
Brand: Effient (US/EU) / Prasita (IN) / Prasurel (IN) / Prasugrel (BD)
Antiplatelet
P2Y12 inhibitor (irreversible, prodrug)
Pharmacokinetics
| Half-life | 7 hours |
| Tmax | 0.5 h |
| Protein Binding | 98 % |
| Volume of Distribution | 0.15 L/kg (approx) |
| Clearance Route | hepatic |
| Active Metabolites | yes |
| Notes | Prodrug but activation is efficient and not genotype-dependent; dose reduction (<60 kg); avoid in age >75 unless high thrombotic risk. | Updated 2025: Comparative analyses show higher bleeding risk vs clopidogrel, particularly in elderly and low-weight patients; 2025 AHA review advises careful selection for ACS/PCI cases; benefits strongest in younger, high-thrombotic-risk patients. | Updated 2025: Comparative analyses show higher bleeding risk vs clopidogrel, particularly in elderly and low-weight patients. 2025 AHA/ESC reviews recommend careful selection for ACS/PCI; benefits greatest in younger, high-thrombotic-risk cases. Reference: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.125.043112 |
⚠️ Safety & Warnings
Severity: Severe
Adverse Effects:
Bleeding (higher risk than clopidogrel), easy bruising, anemia
Contraindications:
History of TIA or stroke (absolute), active bleeding, severe hepatic impairment
Precautions:
Avoid in age >75 unless high-risk PCI; reduce dose if body weight <60 kg; stop 7 days before surgery