Apagrel 5 mg (Tablet)

Indications

• Reduction of thrombotic cardiovascular events
• Management of acute coronary syndrome
• Percutaneous coronary intervention

Pharmacology

• Inhibitor of platelet activation and aggregation
• Irreversible binding to P2Y12 class of ADP receptors

Dosage & Administration

• 60 mg oral loading dose
• Subsequent daily doses of 10 mg
• Consider 5 mg daily for patients <60 kg
• Co-administration with aspirin (75 mg to 325 mg) daily

Interaction

• Increased risk of bleeding with warfarin
• Increased risk of bleeding with NSAIDs
• Co-administration with drugs that are inducers or inhibitors of cytochrome P450 enzymes
• Can be administered with aspirin, heparin, GPIIb/IIIa inhibitors, statins, and drugs that elevate gastric pH

Contraindications

• Active pathological bleeding
• History of prior transient ischemic attack or stroke

Side Effects

• Bleeding
• Thrombotic thrombocytopenic purpura
• Other side effects such as headache, back pain, dyspnea, nausea, hypertension, bradycardia, rash

Pregnancy & Lactation

• No adequate and well-controlled studies in pregnant women
• Potential risk to nursing infant

Precautions & Warnings

• Increased risk of CABG-related bleeding
• Premature discontinuation increases risk of stent thrombosis, MI, and death

Use in Special Populations

• Safety and effectiveness in pediatric patients have not been established
• Increased risk of fatal bleeding events in patients >75 years of age
• No dosage adjustment for patients with renal impairment
• Limited experience in patients with end-stage renal disease
• No dosage adjustment for patients with mild to moderate hepatic impairment

Overdose Effects

• Lethality observed after administration of 2000 mg/kg in rats
• Platelet transfusion may restore clotting ability
• Prasugrel active metabolite not likely to be removed by dialysis

Therapeutic Class

• Anti-platelet drugs

Storage Conditions

• Keep in dry place
• Keep away from light and heat
• Keep out of the reach of children

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