NSTK · 01.2026Independent supplement reference
NutriStack
Edition 1.0Updated July 13, 2026

Prasugrel

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

Prasugrel is a third-generation thienopyridine P2Y12 inhibitor with faster onset, greater potency, and less inter-patient variability than clopidogrel. The TRITON-TIMI 38 trial demonstrated superior efficacy over clopidogrel in ACS patients undergoing PCI, but with higher bleeding risk. Its single-step hepatic activation avoids the CYP2C19 polymorphism issue seen with clopidogrel.

Evidence tier
Strong
Indexed sources
10 2017–2023
Interactions
0
Category
Prescription
Read the sources → Compare profiles
Publication status

Exploratory record, not a reviewed medical publication.

See the editorial and medical-review policies for the publication gate.

This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

Prasugrel is a third-generation thienopyridine P2Y12 inhibitor with faster onset, greater potency, and less inter-patient variability than clopidogrel. NutriStack rates the supporting evidence as strong. Common adult dosing is 60 mg loading dose, then 10 mg once daily (5 mg daily if <60 kg) for up to 12 months with aspirin (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.

What it's good for
  • Superior to clopidogrel in reducing ischemic events in ACS-PCI (TRITON-TIMI 38)6,7
  • Faster onset of platelet inhibition than clopidogrel
  • More consistent antiplatelet effect (not affected by CYP2C19 polymorphism)3,8
  • Greater reduction in stent thrombosis than clopidogrel6,7
What to watch for
  • Bleeding (higher rate than clopidogrel, including life-threatening and fatal bleeding)
  • Bruising
  • Epistaxis
  • Active pathological bleeding3
  • History of prior stroke or TIA (net clinical harm demonstrated)

The bottom line

Evidence rating strong. Most-documented uses: superior to clopidogrel in reducing ischemic events in acs-pci (triton-timi 38), faster onset of platelet inhibition than clopidogrel, more consistent antiplatelet effect (not affected by cyp2c19 polymorphism). 10 sources indexed (2017–2023), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Thienopyridine prodrug that requires only a single CYP-mediated hepatic oxidation step (primarily CYP3A4 and CYP2B6) to generate the active metabolite. The active metabolite irreversibly binds to the platelet P2Y12 ADP receptor, blocking ADP-mediated platelet activation and aggregation. Faster and more complete platelet inhibition than clopidogrel, with minimal impact from CYP2C19 polymorphisms.

Class
Antiplatelet Agent (P2Y12 Inhibitor)
Dosing

Dosing & protocol.

Common range
60 mg loading dose, then 10 mg once daily (5 mg daily if <60 kg) for up to 12 months with aspirin (as prescribed by your physician)
Recommended form
Oral tablet

Can be taken with or without food; rapidly absorbed and converted to active metabolite8,10

Safety

Full safety detail.

Side effects

  • Bleeding (higher rate than clopidogrel, including life-threatening and fatal bleeding)
  • Bruising
  • Epistaxis
  • GI bleeding
  • Anemia
  • Rash
  • Thrombotic thrombocytopenic purpura (TTP, very rare)

Contraindications

  • Active pathological bleeding3
  • History of prior stroke or TIA (net clinical harm demonstrated)
  • Hypersensitivity to prasugrel1,2
  • Generally not recommended in patients >=75 years (increased bleeding risk without net benefit unless high-risk features like diabetes or prior MI)3
Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

5

Reference material

5
FAQ

Common questions.

Quick answers about Prasugrel, drawn from the data on this page.

What is Prasugrel?

Prasugrel is a third-generation thienopyridine P2Y12 inhibitor with faster onset, greater potency, and less inter-patient variability than clopidogrel. The TRITON-TIMI 38 trial demonstrated superior efficacy over clopidogrel in ACS patients undergoing PCI, but with higher bleeding risk. Its single-step hepatic activation avoids the CYP2C19 polymorphism issue seen with clopidogrel.

What is Prasugrel used for?

Commonly cited benefits of Prasugrel include: Superior to clopidogrel in reducing ischemic events in ACS-PCI (TRITON-TIMI 38); Faster onset of platelet inhibition than clopidogrel; More consistent antiplatelet effect (not affected by CYP2C19 polymorphism); Greater reduction in stent thrombosis than clopidogrel. NutriStack rates the overall evidence as strong.

What is a typical dose of Prasugrel?

A typical adult dose of Prasugrel is 60 mg loading dose, then 10 mg once daily (5 mg daily if <60 kg) for up to 12 months with aspirin (as prescribed by your physician). The commonly recommended form is Oral tablet. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Prasugrel?

Reported side effects include bleeding (higher rate than clopidogrel, including life-threatening and fatal bleeding), bruising, epistaxis, gi bleeding, anemia, rash. This is educational information; check with a healthcare professional before use.

How strong is the evidence for Prasugrel?

NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

Prasugrel in NutriStack.

Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.

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NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.