Posts Tagged ‘prasugrel vs clopidogrel in TIA’


Current prescribing information cautions clearly Prasugrel should not  be used in TIA  or recent  stroke (Even in  ischemic strokes -Embolic included !)

The warning  is perplexing and illogical to me.

What is your take ?

I would imagine the following  could be  the reasons.

Prasugrel  as an  antiplatlet agent is  many fold  powerful and could convert all  strokes into hemorrhagic one .

Does Prasugrel convert a TIA into stroke instead of curing it ?

Prasugrel may worsen the stroke  in case the TIA is going to end up as stroke.

Is there any thing called hemorrhagic TIA ?

Since we do not have any mechanism to diagnose Ischemic TIA from hemorrhagic TIA ,  it is better to avoid Prasugrel . It is still a mystery ,  why  clopidogrel which acts on the same receptor and can be safely given for TIA ( pro actively)

After thought

I think Neuro physicians must answer this question . ( Cardiologists  better limit their extended geographical terrain ! )

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