Article Figures & Data
Figures
- Figure 1.
Metabolic pathways of clopidogrel and prasugrel.
Tables
Aspirin Clopidogrel Prasugrel Mechanism of action Decreases platelet aggregation by inhibiting formation of thromboxane A2 Inhibits binding of ADP to platelets and thus inhibits activation of GPIIb/IIIa receptor complex Inhibits binding of ADP to platelets and thus inhibits activation of GPIIb/IIIa receptor complex Receptor/enzyme targeted Inhibits platelet cyclooxygenase 1 and 2 enzymes. Blocks the P2Y12 receptors on platelets Blocks the P2Y12 receptors on platelets Reversible No No No Metabolism Hydrolyzed to salicylate in GI mucosa and then conjugated in the liver; attains peak serum levels in 1–2 hours Prodrug; 85% inactivated; 15% oxidized by CYP450 to active thiol metabolite, which attains peak serum levels in 1 hour Prodrug; major portion oxidized by CYP450 to active metabolite R-138727, which attains peak serum levels in 30 min Interactions Proton pump inhibitors do not significantly interact Proton pump inhibitors reduce serum levels of active metabolite Proton pump inhibitors do not significantly interact ADP, adenosine diphosphate; GI, gastrointestinal.
