Effient (Prasugrel) - Oral

Warning:

Effient (prasugrel) carries a boxed warning, the Food and Drug Administration's (FDA) strictest safety warning for a drug label. The boxed warning states the following:

Prasugrel can cause significant bleeding. This bleeding can result in death in some cases. It should not be used in people with a history of mini-stroke or stroke, who are actively bleeding, or in those 75 years and older. In certain people at high risk (e.g., those with diabetes and a history of a heart attack), prasugrel may be considered for use. However, prasugrel should not be started in people who may need an urgent coronary artery bypass graft surgery (CABG).

Prasugrel should be stopped at least seven days before any surgery. Taking prasugrel may put you at higher risk for bleeding if you weigh less than 132 pounds, have a tendency towards bleeding, or take certain medications that increase the risk of bleeding. These drugs may include warfarin, heparin, or other blood thinners, drugs to dissolve blood clots, or nonsteroidal anti-inflammatory drugs (NSAIDs).

Bleeding should be suspected in any individual with low blood pressure who has recently had coronary angiography (an imaging test to see if there is a blockage in a coronary artery), CABG, percutaneous coronary intervention (a procedure that opens blocked arteries), or other surgeries.

What Is Effient?

Effient (prasugrel) is an oral prescription drug used (in combination with aspirin) to prevent heart attacks, stroke, or other serious heart or blood vessel problems. It is used in people who have had a heart attack or serious chest pain and are to be managed with percutaneous coronary intervention (PCI, also known as angioplasty).

Effient is an antiplatelet drug. It works by stopping platelets from making blood clots.

Effient is available as a tablet that is taken by mouth.

Drug Facts

Generic Name: Prasugrel

Brand Name(s): Effient

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antiplatelet

Available Generically: Yes

Controlled Substance: No

Active Ingredient: Prasugrel

Dosage Form(s): Tablet

What Is Effient Used For?

The Food and Drug Administration (FDA) approved Effient to lower the chance of a heart attack, stroke, or other serious problems with the heart or blood vessels in people with acute coronary syndrome (who have had a heart attack or chest pain) and are to be managed with percutaneous coronary intervention (PCI).

PCI is a procedure that uses a thin, flexible tube called a catheter to place a stent (a self-expanding tube) to open the blood vessels that carry blood to the heart.

Effient should be taken daily with aspirin.

How To Take Effient

If prescribed Effient, read your medication's prescription label and information leaflet. Consult your healthcare provider if you have any questions.

Use Effient precisely as your healthcare provider directs, and do not skip doses. Do not stop taking Effient unless your healthcare provider tells you to. Stopping Effient too soon can increase the risk of a blood clot, heart attack, or death.

Your healthcare provider will tell you how much aspirin to take every day.

Swallow the tablet whole. Do not chew, crush, or break the tablet. You can take it with or without food.

Effient can make you more likely to bleed, even from minor injuries. Get emergency medical help if you have bleeding that will not stop. Notify your healthcare provider if you are having surgery or a dental procedure.

Storage

Store Effient at room temperature (between 68 F and 77 F), away from light, heat, and moisture. The medication will be provided in its original container. Keep the bottle tightly closed when not in use. It comes with a gray cylinder in the bottle called a desiccant, which helps keep the pills dry. Leave the desiccant in the bottle; do not eat or swallow it. Keep Effient out of reach of children and pets to prevent accidental consumption.

How Long Does Effient Take to Work?

The first dose of Effient is called a loading dose. This is a higher first dose, which decreases on the second day. The loading dose helps the medication start working quickly (within 30 minutes). You will need to take it with aspirin each day as directed for it to continue to work properly.

What Are the Side Effects of Effient?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Like other medications, Effient can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

Common side effects of Effient are:

  • Atrial fibrillation (irregular heart rate which can cause a fast and pounding heartbeat)
  • Back pain
  • Bleeding (including nosebleeds, easy bleeding, and bruising)
  • Bradycardia (slow heart rate)
  • Chest pain
  • Cough
  • Diarrhea
  • Dizziness
  • Fever
  • Headache
  • High or low blood pressure
  • High cholesterol
  • Low white blood cells, which can interfere with the body's ability to fight infections
  • Nausea
  • Rash
  • Shortness of breath
  • Swelling and pain in the extremities (hands and feet)
  • Tiredness

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Long-Term Side Effects

While many people tolerate Effient well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Back pain
  • Cough
  • Nosebleeds

Moderate long-term side effects can include:

  • Anemia
  • High cholesterol
  • Low platelets
  • Low white blood cells
  • Swelling of the extremities

Severe long-term side effects may include: 

  • Bleeding in the skull
  • Bleeding in the stomach
  • Thrombotic thrombocytopenic purpura

Report Side Effects

Effient may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to theFDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Effient Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of heart attacks or strokes:
      • Adults weighing 60 kilograms (kg) or more—At first, 60 milligrams (mg) taken as a single loading dose, and then 10 mg once a day. You may take this medicine with aspirin (75 to 325 mg) once a day.
      • Adults weighing less than 60 kg—At first, 60 mg taken as a single loading dose, and then 5 mg once a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Effient.

Before using Effient, consult a healthcare provider about the safety risks if you:

  • Are 65 years or older due to the higher risk of bleeding
  • Weigh less than 132 pounds (People in this weight category tend to absorb more of the drug and have a higher risk of bleeding. Your healthcare provider may prescribe you a lower dose.)
  • Have kidney or liver problems (People with end-stage kidney disease or severe liver disease are at higher risk of bleeding.)
  • Are pregnant, planning to become pregnant, or breastfeeding

Missed Dose

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the regular time. Do not take two doses to make up for a missed dose.

Overdose: What Happens If I Take Too Much Effient?

What Happens If I Overdose on Effient?

If you think you or someone else may have overdosed on Effient, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Effient, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Tell all of your medical doctors, dentists, and nurses that you are taking this medicine. Prasugrel may increase the risk of serious bleeding during an operation or some dental procedures. Treatment may have to be stopped about 7 days before the operation or dental procedure.

Check with your doctor right away if you have the following symptoms: change in mental status, dark or bloody urine, difficulty with speaking, fever, pale color of the skin, pinpoint red spots on the skin, seizures, weakness, yellow eyes or skin. These may be symptoms of a serious condition called thrombotic thrombocytopenic purpura (TTP).

This medicine may cause serious allergic reactions, including angioedema. Angioedema can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have chest pain, a rash, itching, swelling of the face, lips, tongue, or throat, or trouble with swallowing or breathing while you are using the medicine.

Do not stop taking this medicine without checking with your doctor first. To do so may increase your risk for clots.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Effient?

Effient is not appropriate for everyone. You should not take this medication if allergic to prasugrel or any inactive ingredients in Effient. 

You should also not take this medication if you:

  • Are actively bleeding (however, if you already take Effient and are bleeding, get emergency medical help. Do not stop taking the medication unless your healthcare provider tells you to stop.)
  • Have a history of mini-stroke (also called transient ischemic attack, or TIA) or stroke
  • Are having CABG surgery within seven days

Effient may be prescribed with caution in some people only if their healthcare provider determines it is safe. This includes people:

  • 75 years and older (unless they are high-risk as determined by the healthcare provider)
  • Who weigh less than 132 pounds
  • With moderate to severe kidney problems
  • With severe liver problems
  • At risk of bleeding
  • With a history of stomach bleeding
  • With a stomach ulcer or certain stomach conditions
  • Who have had recent surgery or trauma

What Other Medications Interact With Effient?

Tell your healthcare provider about your medications, including prescription and over-the-counter (OTC) drugs and vitamins or supplements. 

Effient should not be taken together with blood thinners (e.g., warfarin, clopidogrel) or chronic NSAID treatment due to the increased risk of bleeding. An exception to this is aspirin, which should be used with Effient to help prevent blood clots. Your healthcare provider will tell you how much aspirin to take.

Other drugs can cause an increased risk of bleeding when combined with Effient, such as:

People who take an antidepressant should consult their healthcare provider.

Opioid pain medicines can make Effient less effective. People who take an opioid pain medication will generally not be prescribed Effient. Instead, your healthcare provider will likely prescribe an injectable antiplatelet treatment. Examples of opioids include Xtampza ER (oxycodone), Percocet (oxycodone and acetaminophen), and Norco (hydrocodone and acetaminophen).

Other drug interactions may occur with Effient. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Effient is a blood thinner. There are two types of blood thinners: antiplatelets and anticoagulants. Effient is an antiplatelet drug.

Other antiplatelet medications include:

Anticoagulants include:

This is a list of drugs that are blood thinners. It is NOT a list of drugs recommended to take with Effient. Talk to your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Effient used for?

    Effient (prasugrel) is an oral prescription medicine used in combination with aspirin to prevent heart attacks, stroke, or other severe heart or blood vessel problems. It is used in people who have had a heart attack or serious chest pain and are to be managed with a PCI.

  • How does Effient work?

    Effient is a blood thinner, specifically an antiplatelet drug, that stops platelets from making clots. This helps to reduce the risk of a heart attack or stroke.

  • What drugs should not be taken with Effient?

    Effient should not be taken with other blood thinners, such as warfarin or clopidogrel. It should also not be used with NSAIDs that are used long-term, such as ibuprofen or naproxen. However, Effient should be combined with a daily aspirin dose. Your healthcare provider will let you know how much aspirin to take.

    Effient can also cause an increased risk of bleeding when taken with certain antidepressants. Additionally, opioid medications can also interact with Effient. You may receive a different blood thinner therapy if you use an opioid.

    Talk to your healthcare provider or pharmacist for more detailed information regarding drug interactions.

  • What are the side effects of Effient?

    Because it thins the blood, Effient can cause bleeding as a side effect. Bleeding can be life-threatening or cause death. You may bleed or bruise easier or have nosebleeds. If you have bleeding that does not stop, get emergency medical help immediately.

    Other common side effects include high or low blood pressure, heart rhythm changes, back or chest pain, dizziness, cough, nausea and diarrhea, fever, headache, high cholesterol, rash, shortness of breath, tiredness, and swelling of the hands and feet. Effient can also cause a decrease in white blood cells, which can interfere with the body's ability to fight infections.

    Before taking Effient, discuss potential side effects with your healthcare provider and what to do if you experience them.

  • How do I stop taking Effient?

    Your healthcare provider will tell you how long to take Effient. Do not stop taking Effient, even if you are bleeding, unless your healthcare provider tells you to. Stopping Effient too soon can increase the risk of having a heart attack or stroke.

How Can I Stay Healthy While Taking Effient?

Before taking Effient, discuss your medical history and all medications you take with your healthcare provider. When taking Effient, follow your healthcare provider’s instructions for use. Read the patient information leaflet with your prescription and ask your healthcare provider if you have any questions.

When you take a blood thinner, you are more prone to bruising and bleeding, and bleeding can take longer to stop. Here are some tips to help you stay as safe as possible:

  • Use an electric razor when shaving. This helps avoid cuts and scrapes.
  • Be careful when using sharp objects, like knives and scissors.
  • Instead of using a nail clipper, file your nails with an emery board.
  • Brush your teeth with a soft-bristled toothbrush. This helps to avoid bleeding gums. Avoid toothpicks.
  • Use a vaporizer or humidifier to keep the air moist, especially in the winter, to help prevent nosebleeds.
  • When blowing your nose, do so gently.
  • Avoid activities with a chance of injury. Ask your healthcare provider what exercise or activities would be safe and appropriate for you.
  • Wear a helmet every time you ride a bike.
  • Always wear a medical alert, so emergency responders know you are taking a blood thinner.
  • If you fall or hit your head, get emergency medical attention immediately. Even if you are not visibly bleeding, you may be bleeding under the skin or in the skull. 
  • Wear shoes or non-slip slippers inside the house, and always wear shoes outside of the house.
  • Wear appropriate gloves for using sharp tools or for working in the yard.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. MedlinePlus. Prasugrel.

  3. Jauregui ME, Umejei OU, Cruz MP. Prasugrel (Effient), an adenosine diphosphate receptor antagonist for the treatment of acute coronary syndrome. P T. 2009;34(8):417-419.

  4. Epocrates. Effient.

  5. Prescribers’ Digital Reference. Prasugrel - drug summary.

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.