Prasugrel: what it is and why doctors prescribe it

Prasugrel is an antiplatelet medicine used to lower the risk of clot-related events after certain heart procedures. Doctors commonly give it to patients with acute coronary syndrome who are having a stent placed during angioplasty. It helps stop platelets from clumping, which reduces the chance of a heart attack or stent clot.

Who should (and shouldn't) take prasugrel

Prasugrel is usually for adults who are having percutaneous coronary intervention (PCI) for unstable angina or a heart attack. It’s stronger than clopidogrel, so it’s chosen when a higher antiplatelet effect is needed. But it’s not right for everyone. If you’ve had a stroke or transient ischemic attack (TIA), prasugrel is generally avoided because it raises bleeding risk.

Older adults need extra caution. People aged 75 or older usually aren’t given the standard dose unless there’s a clear benefit; sometimes doctors pick an alternative or a lower dose. Also, if you weigh less than 60 kg (about 132 lb), a lower dose is often recommended.

How to take prasugrel and key safety tips

Prasugrel is taken by mouth once daily. A typical plan starts with a loading dose when the stent is placed, followed by a daily maintenance dose. Take it with or without food at the same time each day to keep levels steady.

Bleeding is the main risk. Tell every doctor, dentist, or surgeon that you’re on prasugrel before any procedure. Elective surgery should usually wait until prasugrel is stopped—doctors commonly ask patients to stop it about 7 days before surgery to lower bleeding risk. Never stop prasugrel suddenly after a stent without your cardiologist’s advice; stopping early can increase the chance of a dangerous clot.

Watch for signs of serious bleeding: unusual bruising, black or bloody stools, pink or brown urine, coughing or vomiting blood, or prolonged nosebleeds. If any of these happen, get medical help right away.

Prasugrel interacts with other blood thinners and some herbal supplements. Avoid strong NSAIDs (like naproxen or ibuprofen) unless your doctor clears them. Also mention aspirin dose: prasugrel is usually given with low-dose aspirin, not high-dose aspirin.

Pregnancy and breastfeeding: there’s limited data. If you’re pregnant or planning pregnancy, talk to your doctor about safer options. For breastfeeding, discuss risks and benefits with your clinician.

Storage is simple: keep the tablets in the original container at room temperature, away from moisture and heat. Don’t use past the expiry date, and keep medicines out of reach of children.

If you want a deeper look at interactions, alternatives to prasugrel, or how it compares to clopidogrel and ticagrelor, check reliable medical sources or ask your cardiologist. Your situation matters—age, weight, bleeding history, and the type of heart problem will decide the best choice.

HoneyBeeHealth.com has practical guides on antiplatelet drugs and heart care. Use those to prepare questions for your doctor so you get the safest, most effective treatment for your heart.