Hemagrel

Indications

Prasugrel is used together with Aspirin to prevent heart attack, stroke and blood clots in the heart arteries in adults with acute coronary syndrome (a heart attack or unstable angina) who are being treated with angioplasty and a stent (percutaneous coronary intervention).

How It Works

Prasugrel is an antiplatelet medicine. Platelets are blood cells that clump together to form clots. Prasugrel blocks a receptor on platelets (the P2Y12 receptor), so they stick together less. This lowers the chance of a clot forming in a narrowed artery or inside a stent.

Dosage and Administration

Adults: a single loading dose of 60 mg, then 10 mg once a day, taken with Aspirin as prescribed (usually 75 to 150 mg of Aspirin a day).

Adults weighing under 60 kg: 5 mg once a day after the loading dose. People aged 75 or older: usually not recommended; if the cardiologist decides it is needed, 5 mg once a day.

Treatment usually continues for up to 12 months, or as long as the cardiologist advises. It can be taken with or without food. Children: not for use.

If a dose is missed, take it when you remember the same day; do not take two doses together. Never stop Prasugrel without talking to your heart doctor, because stopping early raises the risk of a stent clot and heart attack.

Interactions

• Warfarin, Heparin, Rivaroxaban, Apixaban and other blood thinners raise the risk of bleeding.
• Pain killers such as Ibuprofen, Diclofenac and Naproxen (NSAIDs) raise the risk of stomach bleeding.
• Other antiplatelet medicines such as Clopidogrel or Ticagrelor are not combined with Prasugrel.
• Morphine and other opioids may slow the absorption of Prasugrel.

Tell every doctor and dentist who treats you that you take Prasugrel.

Contraindications

Do not use Prasugrel if you:

• are bleeding now, for example from a stomach ulcer or in the brain;
• have ever had a stroke or a mini-stroke (transient ischaemic attack, TIA);
• have severe liver disease;
• are allergic to Prasugrel or any ingredient of the product.

Side Effects

Common: bruising easily, nosebleeds, bleeding gums, bleeding at the puncture site, blood in the urine, anaemia and rash.

Get urgent medical help if you have:

• black or tarry stools, vomiting blood or material like coffee grounds;
• bleeding that will not stop;
• sudden weakness or numbness of the face, arm or leg, trouble speaking, severe headache or confusion (signs of a stroke);
• fever, unusual paleness, yellow skin and purple spots on the skin (a rare blood disorder called TTP);
• swelling of the face, lips or throat or difficulty breathing.

Pregnancy and Lactation

There is limited information on use in pregnancy. It is used only if the doctor decides the benefit clearly outweighs the risk. It is not known whether Prasugrel passes into breast milk; breastfeeding is generally avoided during treatment. Discuss with your doctor.

Precautions and Warnings

• Bleeding risk is higher if you weigh under 60 kg, are 75 or older, have had recent surgery or injury, or have a stomach ulcer.
• Before any planned surgery or dental extraction, ask your cardiologist; Prasugrel is usually stopped at least 7 days before surgery, but only on the doctor's advice.
• Tell your doctor if you have liver or kidney disease.
• Bleeding may take longer to stop than usual; minor cuts should be pressed firmly.

Overdose

An overdose can cause serious bleeding. Get medical help at once. A platelet transfusion may be given in hospital.

Therapeutic Class

Antiplatelet medicine; P2Y12 receptor inhibitor (thienopyridine).

Storage

Store below 30°C in a dry place, away from light, in the original pack. Keep out of the reach of children.