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The Rationale for and Clinical Pharmacology of Prasugrel 5 mg

Jakubowski, Joseph A.; Erlinge, David LU ; Alexopoulos, Dimitrios; Small, David S.; Winters, Kenneth J.; Gurbel, Paul A. and Angiolillo, Dominick J. (2017) In American Journal of Cardiovascular Drugs 17(2). p.109-121
Abstract

Prasugrel is a third-generation thienopyridine platelet P2Y12 adenosine diphosphate (ADP) receptor antagonist administered with aspirin for the treatment of patients with acute coronary syndrome (ACS) with planned percutaneous coronary intervention. Prasugrel is administered periprocedurally at an oral loading dose of 60 mg followed by daily maintenance doses (MDs) of 10 mg for most patients and 5 mg for patients weighing <60 kg or aged ≥75 years. Data from a prasugrel phase III study, TRITON-TIMI 38, suggested that a lower MD might be more suitable for patients weighing <60 kg or aged ≥75 years; subsequent pharmacokinetic and pharmacodynamic studies have indicated that prasugrel 5 mg reduced platelet reactivity in... (More)

Prasugrel is a third-generation thienopyridine platelet P2Y12 adenosine diphosphate (ADP) receptor antagonist administered with aspirin for the treatment of patients with acute coronary syndrome (ACS) with planned percutaneous coronary intervention. Prasugrel is administered periprocedurally at an oral loading dose of 60 mg followed by daily maintenance doses (MDs) of 10 mg for most patients and 5 mg for patients weighing <60 kg or aged ≥75 years. Data from a prasugrel phase III study, TRITON-TIMI 38, suggested that a lower MD might be more suitable for patients weighing <60 kg or aged ≥75 years; subsequent pharmacokinetic and pharmacodynamic studies have indicated that prasugrel 5 mg reduced platelet reactivity in these populations to an extent similar to that of prasugrel 10 mg in heavier or younger patients. Clinical experience with prasugrel 5 mg is limited, and additional studies are needed to verify the clinical efficacy and safety of this dose in these challenging populations.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Cardiovascular Drugs
volume
17
issue
2
pages
13 pages
publisher
Adis International
external identifiers
  • scopus:84995478815
  • wos:000401559900003
ISSN
1175-3277
DOI
10.1007/s40256-016-0202-3
language
English
LU publication?
yes
id
dc9a364d-4747-4846-87d8-3537239272b2
date added to LUP
2016-12-05 07:52:45
date last changed
2018-01-07 11:38:31
@article{dc9a364d-4747-4846-87d8-3537239272b2,
  abstract     = {<p>Prasugrel is a third-generation thienopyridine platelet P2Y<sub>12</sub> adenosine diphosphate (ADP) receptor antagonist administered with aspirin for the treatment of patients with acute coronary syndrome (ACS) with planned percutaneous coronary intervention. Prasugrel is administered periprocedurally at an oral loading dose of 60 mg followed by daily maintenance doses (MDs) of 10 mg for most patients and 5 mg for patients weighing &lt;60 kg or aged ≥75 years. Data from a prasugrel phase III study, TRITON-TIMI 38, suggested that a lower MD might be more suitable for patients weighing &lt;60 kg or aged ≥75 years; subsequent pharmacokinetic and pharmacodynamic studies have indicated that prasugrel 5 mg reduced platelet reactivity in these populations to an extent similar to that of prasugrel 10 mg in heavier or younger patients. Clinical experience with prasugrel 5 mg is limited, and additional studies are needed to verify the clinical efficacy and safety of this dose in these challenging populations.</p>},
  author       = {Jakubowski, Joseph A. and Erlinge, David and Alexopoulos, Dimitrios and Small, David S. and Winters, Kenneth J. and Gurbel, Paul A. and Angiolillo, Dominick J.},
  issn         = {1175-3277},
  language     = {eng},
  number       = {2},
  pages        = {109--121},
  publisher    = {Adis International},
  series       = {American Journal of Cardiovascular Drugs},
  title        = {The Rationale for and Clinical Pharmacology of Prasugrel 5 mg},
  url          = {http://dx.doi.org/10.1007/s40256-016-0202-3},
  volume       = {17},
  year         = {2017},
}