What are the benefits and risks of prasugrel for the treatment of unstable angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Answer

Head-to-head comparison has shown that whereas prasugrel is more effective at reducing clinical events than clopidogrel is, it is also associated with a higher risk of bleeding.

Prasugrel is potentially harmful as part of a dual-platelet regimen in patients with a stroke history for whom PCI is planned. [42] Owing to excess bleeding without clinical benefit, the US Food and Drug Administration lists a Black Box warning that does not recommend administration of prasugrel to patients who weigh less than 60 kg as well as those aged 75 years or older, unless the risk of recurrent cardiac ischemia outweighs the elevated bleeding risk. [42]


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