Prasugrel HCl

It can cause significant, sometimes fatal, bleeding. Do not use in patients with active pathological bleeding or a history of transient ischemic attack or stroke. In patients greater then or equal to 75 years of age, it is generally not recommended because of the increased risk of fatal and intracranial bleeding and uncertain benefit, except in high-risk patients (diabetes or prior MI), where its effect appears to be greater and its use may be considered. Do not start Prasugrel in patients likely to undergo urgent coronary artery bypass graft surgery (CABG). When possible, discontinue it at least 7 days prior to any surgery. Additional risk factors for bleeding include: Body weight < 60 kg Propensity to bleed Concomitant use of medications that increase the risk of bleeding. Suspect bleeding in any patient who is hypotensive and has recently undergone coronary angiography, Percutaneous coronary intervention (PCI), CABG, or other surgical procedures in the setting of Prasugrel. If possible, manage bleeding without discontinuing it. Stopping Prasugrel, particularly in the first few weeks after acute coronary syndrome, increases the risk of subsequent cardiovascular events .