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prasugrel

prasugrel
Brand names: Effient
Form Strength
TABLET, ORAL 10 mg
Display Platelet-Aggregation Inhibitors Class: 201218
Medication comments:
Anticoagulant / Antiplatelet Stoppage For Procedures
generic (Brand) Dept. Procedure Type
(hover over entry for examples)		 Stop Medication Prior To Procedure Restart after:
prasugrel
(Effient)		 Anesthesia High-risk 7-10 days Restart after 24 hours
Intermediate-risk 7-10 days Restart after 24 hours
Low-risk Requires shared assessment and risk stratification Restart after 24 hours
Patients with high risk of bleeding (eg, old age, history of bleeding tendency, concurrent uses of other anticoagulants/antiplatelets, liver cirrhosis or advanced liver disease, and advanced renal disease) undergoing low- or intermediate-risk procedures should be treated as intermediate or high risk, respectively.
Radiology
 Invasive Procedures 7 days
Paracentesis/Thoracentesis 5 days
Surgery High-risk 7 days Restart after 24 hours
Low-risk No Hold Restart after 24 hours
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: prasugrel (Effient)
Criteria 3: Potentially inappropriate medications: drugs to be used with caution in older adults. (Table 4)
Drug(s) prasugrel
Rationale Increases the risk of major bleeding in older adults compared with cLopidogrel, especially among those 75 years old and older. However, this risk may be offset by cardiovascular benefits in select patients.
Recommendation Use with caution, particularly in adults 75 years old and older.
If prasugrel is used, consider a lower dose (5 mg) for those 75 years old and older.
 Quality of evidence: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 24, 2025
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