How to take prasugrel (Effient) — clear, practical instructions

Prasugrel is a strong antiplatelet medicine used to lower the risk of clots after a heart attack or stent. That benefit comes with a higher chance of bleeding, so knowing how to take it right matters. Below are straightforward, useful rules to follow. Always follow your doctor's orders first.

Basic dosing and timing

For most adults the usual plan is a single 60 mg loading dose given once before a percutaneous coronary intervention (PCI), then 10 mg once daily as a maintenance dose. If you weigh under 60 kg, many doctors drop the maintenance dose to 5 mg daily to reduce bleeding risk. If you miss a dose of your daily tablet, take it as soon as you remember that day — don’t double up the next day.

Take prasugrel at roughly the same time each day. You can take it with or without food. Don’t stop prasugrel suddenly without talking to your cardiologist — stopping early can raise the risk of a dangerous clot, especially after a stent.

Safety tips and common interactions

Do not take prasugrel if you’ve had a stroke or transient ischemic attack (TIA) — that’s a clear contraindication because the bleeding risk is too high. People 75 or older are usually given prasugrel only in special cases because age raises bleeding risk. Tell your doctor about any recent bleeding, major surgery, or bleeding disorders.

Prasugrel is normally used together with aspirin (dual antiplatelet therapy). Avoid taking it with other blood thinners (like warfarin) or frequent use of NSAIDs (ibuprofen, naproxen) unless your doctor says it’s okay — mixing increases bleeding risk. Be honest about all pills and supplements you take: herbal products like St. John’s wort, and some prescription meds, can change how prasugrel works or raise risk.

If you’re scheduled for surgery or a dental procedure, tell the surgeon and your cardiologist. Most doctors recommend stopping prasugrel about 7 days before an elective surgery to let platelet function recover, but do not stop it on your own — your care team must decide when it’s safe.

Watch for bleeding signs: unexpected bruises, nosebleeds that won’t stop, pink or dark urine, black or tarry stools, heavy or unusual menstrual bleeding, or coughing/vomiting blood. Seek immediate care for sudden severe headache, slurred speech, weakness, or any sign of stroke or major bleeding.

Store prasugrel at room temperature, dry and out of reach of children. If you’re pregnant, breastfeeding, or have severe liver disease, discuss risks and alternatives with your doctor — prasugrel may not be the best choice.

Bottom line: take the prescribed loading and daily dose, keep your care team updated on other medicines and procedures, and contact your doctor right away if you notice bleeding or signs of stroke. That keeps the protection against clots working while lowering avoidable risks.