Prasugrel Hydrochloride

Adults: For adults, Prasugrel is started with a single 60 mg loading dose and then continued at 10 mg once a day. People taking it should also take ASA every day (75 mg to 325 mg). In patients with acute coronary syndrome (ACS) who are managed with PCI, stopping any antiplatelet agent too early, Prasugrel included, could increase the risk of thrombosis, myocardial infarction or death because of the patient's underlying disease. Treatment for up to 12 months is recommended, unless stopping Prasugrel is clinically indicated. Patients ≥75 years old: use in this age group is generally not recommended. If the prescribing physician weighs the benefit and risk carefully for the individual patient and decides treatment is necessary in patients ≥75 years of age, a 60 mg loading dose should be followed by a reduced maintenance dose of 5 mg. Patients ≥75 years of age are more sensitive to bleeding and have higher exposure to the active metabolite of prasugrel. Patients weighing <60 kg: give a single 60 mg loading dose and then continue at 5 mg once daily. The 10 mg maintenance dose is not recommended. This is because exposure to the active metabolite of prasugrel increases, and so does the risk of bleeding, in patients with body weight <60 kg when they are given 10 mg once daily, compared with patients <60 kg. Renal impairment: no dose adjustment is needed for patients with renal impairment, including those with end-stage renal disease. Hepatic impairment: no dose adjustment is needed in subjects with mild to moderate hepatic impairment (Child-Pugh class A and B). Therapeutic experience in patients with mild and moderate hepatic dysfunction is limited. Children and adolescents: Prasugrel is not recommended for children below 18 years of age, because there is a lack of data on safety and efficacy.