Prasugrel, Ticagrelor, Clopidogrel (Efficacy)

Clopidogrel, ticagrelor and prasugrel are three antithrombotic drugs used in the treatment of cardiovascular diseases. All three drugs act by inhibiting the platelet aggregation, thus avoiding or undoing the thrombi. The action mechanism of the three drugs is based on inhibiting the platelet receptor P2Y12. However, ticagrelor and prasugrel, which have been recently approved by the Food and Drug Administration (FDA), have a more potent effect than clopidogrel (they demonstrate a greater reduction in mortality and recurrent ischemic events) which was the common prescribed treatment until the approval of the new antiplatelet drugs. However, prasugrel and ticagrelor have greater adverse effects than clopidogrel, therefore, in cases in which it is not necessary, clopidogrel is prescribed as it also supposes a lower economic cost. Among the adverse effects of prasugrel-ticagrelor versus clopidogrel, treatment with the former is associated with an increased risk of bleeding and haemorrhage.

Gene or region studied

  • CYP2C19
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