Prasugrel
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| Trade names | Effient, Efient |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a609027 |
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Oral |
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| Bioavailability | ≥79% |
| Protein binding | Active metabolite: ~98% |
| Biological half-life | ~7 h (range 2 h to 15 h) |
| Excretion | Urine (~68% inactive metabolites); feces (27% inactive metabolites) |
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| ECHA InfoCard | 100.228.719 |
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| Formula | C20H20FNO3S |
| Molar mass | 373.442 g/mol |
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Prasugrel (trade name Effient in the US and India, and Efient in the EU) is a pharmaceutical drug that acts as a platelet inhibitor and is used to prevent formation of blood clots. It was developed by Daiichi Sankyo Co. and produced by Ube and currently marketed in the United States in cooperation with Eli Lilly and Company.
Prasugrel was approved for use in Europe in February 2009, and in the US in July 2009, for the reduction of thrombotic cardiovascular events (including stent thrombosis) in people with acute coronary syndrome (ACS) who are to be managed with percutaneous coronary intervention (PCI).
Prasugrel is used in combination with low dose aspirin to prevent thrombosis in patients with ACS, including unstable angina pectoris, non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI), who are planned for treatment with PCI. In studies, prasugrel was more effective than the related clopidogrel but also caused more bleeding. Overall mortality was the same.
Prasugrel does not change the risk of death when given to people who have had a STEMI or NSTEMI. Prasugrel does however increase the risk of bleeding and may decrease the risk of further cardiovascular problems. Thus routine use in NSTEMI patients is of questionable value.
Prasugrel should not be given to patients with active pathological bleeding, such as peptic ulcer or a history of transient ischemic attack or stroke, because of higher risk of stroke (thrombotic stroke and intracranial hemorrhage).
Adverse effects include:
As opposed to clopidogrel, proton pump inhibitors do not reduce the antiplatelet effects of prasugrel and hence it is relatively safe to use these medications together.
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