Prasugrel Dosage: What to Take, When, and Why It Matters

Prasugrel is a strong blood thinner used with aspirin after certain heart procedures to lower the chance of clots. Knowing the right dose helps protect you from heart attacks but also lowers the risk of serious bleeding. Here’s a clear, practical rundown so you know what to expect and when to call your doctor.

Standard Dosing: Loading and Maintenance

The usual approach starts with a single loading dose of 60 mg, given once before or at the time of a percutaneous coronary intervention (PCI). After that, the common maintenance dose is 10 mg taken once daily. Prasugrel works quickly and the loading dose gives fast platelet inhibition when immediate protection is needed.

For people who weigh less than 60 kg (about 132 lbs), the maintenance dose is usually reduced to 5 mg once daily to lower bleeding risk. If you miss a dose, take it as soon as you remember that day — don’t double the next day.

Who Needs Caution or Different Dosing?

Prasugrel is not right for everyone. It’s contraindicated if you’ve had a stroke or transient ischemic attack (TIA) in the past — that history raises the risk of severe bleeding. People aged 75 or older are typically treated with extra caution; doctors may avoid prasugrel unless there’s a clear benefit (for example, prior heart attack or diabetes where benefit outweighs risk).

Also tell your doctor about other blood thinners, NSAIDs, or herbal supplements that increase bleeding risk. Combining prasugrel with strong anticoagulants raises bleeding chances significantly, so your care team will balance risks carefully.

Prasugrel irreversibly inhibits platelets. That means its effect lasts until your body makes new platelets — roughly 7 to 10 days. Because of this, most doctors ask you to stop prasugrel about 7 days before scheduled surgery. Always confirm timing with your surgeon or cardiologist first.

Take prasugrel with or without food, and swallow the tablet with water. Store it at room temperature away from moisture. If you have trouble swallowing pills, ask your pharmacist if the tablet can be handled differently — but don’t change how you take it without guidance.

Watch for warning signs of bleeding: unexpected bruises, black or bloody stools, pink or brown urine, coughing or vomiting blood, severe headache, or sudden weakness. If any of these happen, seek medical help right away.

Final note: dosing can vary based on your health, weight, and other meds. Use this as a practical primer, but follow the exact plan your doctor gives you. If anything is unclear—call your cardiology nurse or pharmacist. They deal with these questions daily and can give answers tailored to your situation.