Contraindicated in:
- Hypersensitivity
- Active pathological bleeding
- History of transient ischemic attack or stroke.
Use Cautiously in:
- Patients about to undergo coronary artery bypass grafting (CABG) (↑ risk of bleeding; discontinue at least 7 days prior to surgery)
- Premature discontinuation (↑ risk of stent thrombosis, MI, and death)
- Body weight <60 kg, propensity to bleed, severe hepatic impairment, concurrent use of medications that ↑ the risk of bleeding (↑ risk of bleeding)
- Hypotension in the setting of recent coronary angiography, PCI, CABG, or other surgical procedure (suspect bleeding but do not discontinue prasugrel)
- OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
- Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
- Pedi: Safety and effectiveness not established in children
- Geri: Appears on Beers list. ↑ risk of major bleeding compared to clopidogrel, especially in patients
75 yrs old. Use with caution in older adults, especially in patients 75 yrs old. If used in patients 75 yrs old, consider using a lower dose (5 mg once daily).