【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，用於75歲以上老年人時須謹慎使用。

抗血小板口服 Acute coronary syndrome to be managed with percutaneous coronary intervention (PCI)
To reduce the rate of thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndrome (ACS) who are to be managed with PCI for unstable angina (UA), NSTEMI, or STEMI
#仿單變更2021

Antiplatelet Agent (an irreversible P2Y12 inhibitor)

Absorption
1. Tmax: 30 min (ESRD: 0.5-1 hour)
2. Bioavailability: rapidly absorbed
3. Effects of food: delayed absorption but no effect on extent of absorption
Distribution
1. Vd: 44 to 68 L (active metabolite)
2. Protein binding, active metabolite, human serum albumin: 98%
Metabolism
1. Hepatic: extensive via hydrolysis in the intestine and to active metabolite by CYP3A and CYP2B6
2. Metabolite (=R-138727): active
Excretion
Renal: 68-70%; Fecal: 25-27%
Pharmacodynamics
1. Elimination Half Life of R-138727 (active metabolite): adults, 7 to 8 hours (range 2-15 hours)
2. Duration of effect: Platelet aggregation gradually returns to baseline values over 5-9 days after discontinuation

1. Hypersensitivity to prasugrel or any component of the formulation
2. Active pathological bleeding (eg, hemophilia, peptic ulcer, intracranial hemorrhage)
3. Prior TIA or stroke

Fetal risk cannot be ruled out.

Avoid

1. Cardiovascular: Hypertension, hyperlipidemia, atrial fibrillation, bradyarrhythmia, angioedema
2. Central nervous system: headache, dizziness, fatigue
3. Gastrointestinal: nausea, diarrhea
3. Neuromuscular & skeletal: back pain
4. Hematologic & oncologic: hemorrhage, epistaxis, leukopenia, thrombotic thrombocytopenic purpura(TTP)
5. Respiratory: dyspnea
6. Post-marketing/serious: jaundice, abnormal liver function, agranulocytosis, pancytopenia <2021/11/8>

Loading dosage (day1): 20mg once daily
Maintenance dosage: 3.75mg/day (in combination with aspirin)

no data

No dosage adjustment necessary; use caution in moderate to severe impairment (patients are generally at higher risk of bleeding)

1. Mild to moderate hepatic impairment (Child-Pugh class A and B): No dosage adjustment necessary
2. Severe hepatic impairment (Child-Pugh class C): There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use caution (patients are generally at higher risk of bleeding)

Store at 25°C