243 Potential cross-reactivity between prasugrel and other antiplatelet agents

Abstract

BackgroundPrasugrel is a third-generation thienopyridine antiplatelet agent with efficacy in the management of acute coronary syndrome in planned percutaneous coronary intervention (PCI). It became available to Canadian patients in June 2010. It is attractive as an alternative agent in patients who have experienced adverse reactions to clopidogrel. However, cross-reactivity between prasugrel and clopidogrel is unknown. We report our experience with five patients receiving prasugrel with previous documented rash and/or urticaria with clopidogrel.MethodsFive consecutive patients prescribed prasugrel 10mg daily post PCI and stent insertion were followed up post discharge.ResultsTabled 1ConclusionOur experience with five patients with previous skin reactions to clopidogrel suggests that there still may be a risk of cross-reactivity between clopidogrel and prasugrel. Further clinical information is needed. In addition, the importance of determining patients' financial coverage for prasugrel as well as facilitating its availability in community pharmacies post-discharge is essential to ensuring that doses are not unintentionally missed. In these patients, this continuity of care was provided by the clinical pharmacist liaising with the patients' community pharmacist. BackgroundPrasugrel is a third-generation thienopyridine antiplatelet agent with efficacy in the management of acute coronary syndrome in planned percutaneous coronary intervention (PCI). It became available to Canadian patients in June 2010. It is attractive as an alternative agent in patients who have experienced adverse reactions to clopidogrel. However, cross-reactivity between prasugrel and clopidogrel is unknown. We report our experience with five patients receiving prasugrel with previous documented rash and/or urticaria with clopidogrel. Prasugrel is a third-generation thienopyridine antiplatelet agent with efficacy in the management of acute coronary syndrome in planned percutaneous coronary intervention (PCI). It became available to Canadian patients in June 2010. It is attractive as an alternative agent in patients who have experienced adverse reactions to clopidogrel. However, cross-reactivity between prasugrel and clopidogrel is unknown. We report our experience with five patients receiving prasugrel with previous documented rash and/or urticaria with clopidogrel. MethodsFive consecutive patients prescribed prasugrel 10mg daily post PCI and stent insertion were followed up post discharge. Five consecutive patients prescribed prasugrel 10mg daily post PCI and stent insertion were followed up post discharge. ResultsTabled 1 ConclusionOur experience with five patients with previous skin reactions to clopidogrel suggests that there still may be a risk of cross-reactivity between clopidogrel and prasugrel. Further clinical information is needed. In addition, the importance of determining patients' financial coverage for prasugrel as well as facilitating its availability in community pharmacies post-discharge is essential to ensuring that doses are not unintentionally missed. In these patients, this continuity of care was provided by the clinical pharmacist liaising with the patients' community pharmacist. Our experience with five patients with previous skin reactions to clopidogrel suggests that there still may be a risk of cross-reactivity between clopidogrel and prasugrel. Further clinical information is needed. In addition, the importance of determining patients' financial coverage for prasugrel as well as facilitating its availability in community pharmacies post-discharge is essential to ensuring that doses are not unintentionally missed. In these patients, this continuity of care was provided by the clinical pharmacist liaising with the patients' community pharmacist.