Drug reference

Prasugrel

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 250

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

In combination with aspirin for the prevention of atherothrombotic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention ▶BY MOUTH ▶Adult 18–74 years (body-weight up to 60 kg): Initially 60 mg for 1 dose, then 5 mg once daily usually for up to 12 months ▶Adult 18–74 years (body-weight 60 kg and above): Initially 60 mg for 1 dose, then 10 mg once daily usually for up to 12 months ▶Adult 75 years and over: Initially 60 mg for 1 dose, then 5 mg once daily usually for up to 12 months Patients undergoing coronary angiography within 48 hours of admission for unstable angina or NSTEMI ▶BY MOUTH ▶Adult: Loading dose 60 mg, not to be administered until the time of percutaneous coronary intervention in order to minimise the risk of bleeding, maintenance dose of 10 mg or 5 mg daily should then be selected as appropriate based on age and weight

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Contra Indications

Active bleeding. history of stroke or transient ischaemic attack

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Cautions

Body-weight less than 60 kg. discontinue at least 7 days before elective surgery if antiplatelet effect not desirable. elderly. patients at increased risk of bleeding (e.g. from recent trauma, surgery, gastro-intestinal bleeding, or active peptic ulcer disease)

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Allergy And Cross Sensitivity

Caution in patients with history of hypersensitivity reactions to thienopyridines (e.g. clopidogrel).

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National Funding Access Decisions

NICE decisions ▶Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes (July 2014) NICE TA317 Prasugrel 10 mg in combination with aspirin is recommended as an option, within its marketing authorisation, for preventing atherothrombotic events in adults with acute coronary syndrome (unstable angina (UA), non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation myocardial infarction (STEMI)) having primary or delayed percutaneous coronary intervention. www.nice.org.uk/guidance/ta317 Scottish Medicines Consortium (SMC) decisions The Scottish Medicines Consortium has advised (September 2009) that prasugrel (Eﬁent ®), in combination with aspirin, be accepted for restricted use within NHS Scotland for the prevention of atherothrombotic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention who are eligible to receive the 10 mg dose of prasugrel.

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Safety

Interactions

→Appendix 1: prasugrel

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Side Effects

▶Common or very common Anaemia. haemorrhage. skin reactions ▶Rare or very rare Thrombocytopenia

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Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk.

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Breast Feeding

Manufacturer advises avoid—no information available.

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Hepatic Impairment

Manufacturer advises caution in moderate impairment (increased risk of bleeding, limited information available); avoid in severe impairment (no information available).

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Renal Impairment

Use with caution—increased risk of bleeding.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Prasugrel (Non-proprietary) Prasugrel 5 mg Prafsia 5mg tablets | 28 tablet P £47.56 DT = £19.30 Prasugrel 5mg tablets | 28 tablet P £47.56 DT = £19.30 Prasugrel 10 mg Prasugrel 10mg tablets | 28 tablet P £47.56 DT = £5.97 Prafsia 10mg tablets | 28 tablet P £47.56 DT = £5.97 ▶Efient (Daiichi Sankyo UK Ltd) Prasugrel 5 mg Efient 5mg tablets | 28 tablet P £47.56 DT = £19.30 Prasugrel 10 mg Efient 10mg tablets | 28 tablet P £47.56 DT = £5.97

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Dose text by age group

Adult 18–74 years (body-weight up to 60 kg)

Initially

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult 18–74 years (body-weight 60 kg and above)

Initially

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult 75 years and over

Initially 60 mg for 1 dose, then

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult

Loading dose 60 mg, not to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Prasugrel

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 250

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 250

Contra Indications

Active bleeding. history of stroke or transient ischaemic attack

PDF page 250

Cautions

PDF page 250

Allergy And Cross Sensitivity

Caution in patients with history of hypersensitivity reactions to thienopyridines (e.g. clopidogrel).

PDF page 250

National Funding Access Decisions

PDF page 250

Safety

Interactions

→Appendix 1: prasugrel

PDF page 250

Side Effects

▶Common or very common Anaemia. haemorrhage. skin reactions ▶Rare or very rare Thrombocytopenia

PDF page 250

Pregnancy

Manufacturer advises use only if potential beneﬁt outweighs risk.

PDF page 250

Breast Feeding

Manufacturer advises avoid—no information available.

PDF page 250

Hepatic Impairment

Manufacturer advises caution in moderate impairment (increased risk of bleeding, limited information available); avoid in severe impairment (no information available).

PDF page 250

Renal Impairment

Use with caution—increased risk of bleeding.

PDF page 250

Dose and formulations

Medicinal Forms

PDF page 250

Dose text by age group

Adult 18–74 years (body-weight up to 60 kg)

Initially

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult 18–74 years (body-weight 60 kg and above)

Initially

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult 75 years and over

Initially 60 mg for 1 dose, then

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Adult

Loading dose 60 mg, not to be administered

First-line fragment. Read the complete Indications and Dose section above.

PDF page 250

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.