Prasugrel - Australian Prescriber

Prasugrel - Australian Prescriber
Prasugrel

(Aust Prescr 2010;33:22-7)

Effient (Eli Lilly)
5 mg and 10 mg tablets
Approved indication: recurrent myocardial infarction
Australian Medicines Handbook section 7.2.2

Patients with myocardial infarction are at high risk of recurrence. Dual antiplatelet therapy, such as aspirin and clopidogrel, has been shown to reduce this risk.

Prasugrel, an adenosine diphosphate receptor antagonist of the thienopyridine class, is a new antiplatelet drug. It works by inhibiting platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y₁₂ receptor on platelets. After oral administration, prasugrel is metabolised mainly by cytochrome P450 3A4 and 2B6. Its elimination half-life is 7.4 hours with the majority of the dose being excreted in the urine.

In a pharmacodynamic study of patients with acute coronary syndrome, prasugrel (60 mg loading dose, then 10 mg daily) was found to be a more potent inhibitor of platelet aggregation than clopidogrel (600 mg loading dose then 150 mg daily) in ex vivo blood tests.......