Indications for EFFIENT:
To reduce risk of thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndrome who are to be managed with percutaneous coronary intervention (patients with unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI); patients with ST-elevation MI (STEMI) when managed with either primary or delayed PCI).
Loading dose: 60mg once. Maintenance: 10mg once daily. <60kg: consider 5mg once daily. Take with aspirin (75mg–325mg daily).
Active pathological bleeding (eg, peptic ulcer, intracranial hemorrhage). Prior TIA or stroke. Do not start if patient likely to undergo urgent CABG.
Patients ≥75yrs: usually not recommended. Weight <60kg, or CABG or other surgery or trauma, recent or recurrent GI bleeding, severe hepatic dysfunction, moderate-to-severe renal impairment: increased risk of bleeding. Discontinue 7 days before surgery, and if TIA or stroke occurs. Premature discontinuation increases risk for cardiac events (eg, stent thrombosis, MI, death). Pregnancy. Nursing mothers.
P2Y12 platelet inhibitor (thienopyridine).
Increased bleeding risk with heparin, warfarin, fibrinolytics, chronic NSAID use. Antagonized by opioid agonists (eg, morphine, others); consider using IV anti-platelet agent instead.
Bleeding (may be fatal), hyper- or hypotension, hyperlipidemia, headache, back pain, GI upset, dizziness, cough, chest pain, atrial fibrillation, leukopenia; rare: thrombotic thrombocytopenic purpura, thrombocytopenia, anemia, abnormal hepatic function, hypersensitivity reactions, angioedema.