Names and pronunciation
(pra′soo-grel) Effient
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Individual generic drug information
Extracted information for prasugrel only.
(pra′soo-grel) Effient
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Func. class.: Platelet aggregation inhibitor
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Chem. class.: ADP receptor antago- nist
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ACTION: Inhibits ADP-induced platelet aggregation
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USES: Reducing the risk of stroke, MI, vascular death, peripheral arterial disease in high-risk patients
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Extracted information for prasugrel only.
CONTRAINDICATIONS: Hyper sensitivity, stroke, TIA, active bleeding, hepatic disease (Child-Pugh C)
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Black Box Warning: Active bleeding Precautions: Pregnancy, breastfeeding, children, geriatric patients, hepatic dis- ease, increased bleeding risk, neutropenia, agranulocytosis, renal disease, surgery, trauma, thrombotic thrombocytopenic purpura, Asian patients, weight <60 kg, CABG, abrupt discontinuation Black Box Warning: Bleeding: may be fatal, decreased B/P in those who have had CABG may be the first indication; bleeding should be controlled while con- tinuing product; may use transfusion; do not use within 1 wk of CABG; may use lower doses in those <60 kg • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk • Beers: avoid use in those age ≥75 yr; increased bleeding risk Black Box Warning: To report any unu- sual bruising, bleeding to prescriber; that it may take longer to stop bleeding • To take with food or just after eating to minimize GI discomfort • To report diarrhea, skin rashes, sub- cutaneous bleeding, chills, fever, sore throat • To tell all health care providers that prasugrel is being used; that product may be held before surgery
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SIDE EFFECTS CNS: Headache, dizziness, intracranial hemorrhage CV: Edema, atrial fibrillation, brady- cardia, chest pain, hypo/hypertension, angina GI: Nausea, vomiting, diarrhea HEMA: Epistaxis, leukopenia, thrombocy- topenia, neutropenia, anaphylaxis, angio- edema, anemia INTEG: Rash, hypercholesterolemia MISC: Fatigue, intracranial hemorrhage, secondary malignancy, angioedema anaphylaxis MS: Back pain
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INTERACTIONS Increase: bleeding risk—anticoagulants, aspirin, NSAIDs, abciximab, eptifibatide, tirofiban, thrombolytics, ticlopidine, SSRIs, treprostinil, rifAMPin
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Extracted information for prasugrel only.
DOSAGE AND ROUTES • Adult/geriatric <75 yr and ≥60 kg: PO 60 mg, then 10 mg daily with aspirin (75- 325 mg/day) • Adult/geriatric <75 yr and <60 kg: PO 60 mg, then 5 mg daily • Geriatric ≥75 yr: not recommended
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Available forms: Tabs 5, 10 mg
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Administer: • With food to decrease gastric symptoms • Do not break tablets, tablet may be crushed and mixed in food, fluids • Do not discontinue therapy abruptly
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Extracted information for prasugrel only.
Assess: • Thrombotic/thrombocytic purpura: fever, thrombocytopenia, neurolytic anemia • Hepatic studies: AST, ALT, bilirubin, creatinine with long-term therapy • Blood studies: CBC, differential, Hct, HB, PT, cholesterol with long-term therapy
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Evaluate: • Therapeutic response: absence of stroke, MI
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That blood work will be necessary dur- ing treatment
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Extracted information for prasugrel only.
PHARMACOKINETICS Rapidly absorbed; peak 30 min; metabo- lized by liver (CYP3A4; CYP2B6); excreted in urine, feces; half-life 7 hr
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Filter the extracted dose blocks for this individual drug.
• Adult/geriatric <75 yr and ≥60 kg: PO 60 mg, then 10 mg daily with aspirin (75- 325 mg/day)
Candidate age grouping · source page 1074
• Adult/geriatric <75 yr and <60 kg: PO 60 mg, then 5 mg daily
Candidate age grouping · source page 1074
• Geriatric ≥75 yr: not recommended
Candidate age grouping · source page 1074