Introduction
Appras 5 belongs to a group of medicines called antiplatelets or blood thinners. It helps prevent the formation of harmful blood clots and keeps the blood flowing smoothly through your body. This lowers the chances of another heart attack or stroke in people with heart disease.
Appras 5 is used to treat people with a recent heart attack or severe heart-related chest pain (unstable angina), who have undergone stenting of the heart. It helps to prevent serious heart-related problems like having another heart attack, stroke, or formation of blood clots in stents.
Your doctor will also prescribe aspirin, another antiplatelet medicine, along with it. This medicine may be taken with or without food and should be taken regularly at the same time each day. It is important to keep taking this medicine even if you feel well. If you stop taking this medicine, it may increase your chances of having another heart attack or stroke.
The most common side effect seen with this medicine is bleeding. This may be in the form of bruising, nose bleeds, blood in urine or stools (black colored stools), or heavier periods than usual in women. If you cut or injure yourself, it may take longer than usual for the bleeding to stop. Such episodes of bleeding are usually mild and resolve on their own. However, you should consult your doctor straight away if the bleeding persists or worries you.
This medicine is not suitable for some people. Do not take it if you are bleeding from anywhere in the body such as a stomach ulcer or bleeding within the brain, or if you have severe liver problems. Before taking it, you should let your doctor know if you have ever had a problem with your blood not clotting properly or if you have recently had a serious injury or surgery. This medicine may need to be stopped temporarily before planned surgery or dental treatment. Pregnant or breastfeeding women should also consult their doctor before taking it.
Uses of Appras 5
- Prevention of heart attack and stroke
- Heart attack
How to use Appras 5
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Appras 5 may be taken with or without food, but it is better to take it at a fixed time.
How Appras 5 works
Appras 5 is an antiplatelet medication. It works by preventing platelets from sticking together, thereby decreasing the formation of harmful blood clots. This lowers the chances of another heart attack or stroke.
What if you forget to take Appras 5?
If you miss a dose of Appras 5, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Acute coronary syndromes, thrombotic cardiovascular (CV) events, stent thrombosis, unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), ST-elevation myocardial infarction (STEMI), Stroke
Administration
May be taken with or without food.
Adult Dose
Oral
Acute coronary syndrome
Adult: 60 mg as loading dose, followed by 10 mg once daily for up to 12 mth, given in combination w/ aspirin.
Elderly: >75 yr Maintenance: 5 mg once daily.
Patient w/ low body wt (<60 kg): 5 mg once daily as maintenance dose.
Hepatic impairment: Severe (Child-Pugh class C): Contraindicated.
Renal Dose
Renal impairment
Dose adjustment not necessary
Contraindication
Active pathological bleeding such as peptic ulcer or intracranial hamorrhage. Patient with a history of prior transient ischemic attack or stroke
Mode of Action
Prasugrel is a prodrug that inhibits platelet activation and aggregation. The active metabolite irreversibly blocks the P2Y12 component of adenosine diphosphate (ADP) receptors on the platelet, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet activation and aggregation.
Precaution
Patient w/ propensity to bleed, low body wt (<60 kg). Patient who will undergo CABG and other surgical procedure; coronary angiography in UA/NSTEMI patients. Elderly (>75 yr). Pregnancy and lactation. Monitoring Parameters Monitor Hb and haematocrit periodically; may consider platelet function testing.
Side Effect
1-10%
Bleeding,Anemia,Atrial fibrillation,Back pain,Bradycardia,Dizziness,Dyspnea,Headache,Hypertension,Nausea
<1%
Thrombotic thrombocytopenic purpura,Abnormal hepatic function,Angioedema,Hematoma,Hemolysis,Hemorrhage,Abnormal liver function
Interaction
Increased risk of bleeding w/ oral anticoagulants (e.g. warfain), clopidogrel, NSAIDs and fibrinolytics.