Two medicines, side by side
Clopidogrel vs prasugrel
Clopidogrel and prasugrel are both labeled for angina and heart attack and coronary artery disease. Drugs@FDA records approvals of clopidogrel since 1997 and of prasugrel since 2009. Pharmacies paid $0.0472 per clopidogrel 75 mg tablet and $0.263 per prasugrel 10 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Clopidogrel, “Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets.”; Prasugrel, “Prasugrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets.”
Check it at the source: the clopidogrel FDA label on DailyMed (effective May 30, 2025); the prasugrel FDA label on DailyMed (effective February 11, 2025).
Highlights of the clopidogrel record
Clopidogrel (Plavix) · label of May 30, 2025
DIMINISHED ANTIPLATELET EFFECT IN PATIENTS WITH TWO LOSS-OF-FUNCTION ALLELES OF THE CYP2C19 GENE WARNING: DIMINISHED ANTIPLATELET EFFECT IN PATIENTS WITH TWO LOSS-OF-FUNCTION ALLELES OF THE CYP2C19 GENE See full prescribing information for complete boxed warning. Effectiveness of Plavix depends on conversion to an active metabolite by the cytochrome P450 (CYP) system, principally CYP2C19. ( 5.1 , 12.3 ) Tests are available to identify patients who are CYP2C19 poor metabolizers.
Used for
From the label: indicationsPlavix is a P2Y 12 platelet inhibitor indicated for: Acute coronary syndrome – For patients with non–ST-segment elevation ACS (unstable angina [UA]/non–ST-elevation myocardial infarction [NSTEMI]), Plavix has been shown to reduce the rate of myocardial infarction (MI) and stroke. ( 1.1 ) – For patients with ST-elevation myocardial infarction (STEMI), Plavix has been shown to reduce the rate of MI and stroke. […]
On the market
- Earliest approval on file
- November 17, 1997
- Generic labelers
- 35 labelers
- Pharmacy cost
- $0.0472 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 6
Highlights of the prasugrel record
Prasugrel (Effient) · label of February 11, 2025
BLEEDING RISK Prasugrel tablets can cause significant, sometimes fatal, bleeding [see Warnings and Precautions ( 5.1 , 5.2 ) and Adverse Reactions ( 6.1 )]. Do not use prasugrel tablets in patients with active pathological bleeding or a history of transient ischemic attack or stroke [see Contraindications ( 4.1 , 4.2 )].
Used for
From the label: indicationsPrasugrel tablets is a P2Y 12 platelet inhibitor indicated for the reduction of thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndrome who are to be managed with percutaneous coronary intervention (PCI) as follows: Patients with unstable angina or non-ST-elevation myocardial infarction (NSTEMI) ( 1.1 ). […]
On the market
- Earliest approval on file
- July 10, 2009
- Generic labelers
- 10 labelers
- Pharmacy cost
- $0.263 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Clopidogrel label of May 30, 2025, Prasugrel label of February 11, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do clopidogrel and prasugrel differ on the record?
How each works, in its label's words: Clopidogrel, “Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets.”; Prasugrel, “Prasugrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets.”
Both are in FDA's class p2y12 platelet inhibitors.
Half-life, in each label's words: Clopidogrel, “After a single, oral dose of 75 mg, clopidogrel has a half-life of approximately 6 hours.”; Prasugrel, “The active metabolite has an elimination half-life of about 7 hours (range 2-15 hours).”
Both labels carry a boxed warning; the records quote them.
Generics: clopidogrel since 2008; prasugrel since 2017 (Drugs@FDA).
| Clopidogrel | Prasugrel | |
|---|---|---|
| Labeled for | Heart attack and coronary artery disease, Angina | Heart attack and coronary artery disease, Angina |
| Pharmacologic class | P2Y12 Platelet Inhibitor | P2Y12 Platelet Inhibitor |
| How it works (label) | Clopidogrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets. | Prasugrel is an inhibitor of platelet activation and aggregation through the irreversible binding of its active metabolite to the P2Y 12 class of ADP receptors on platelets. |
| Half-life (label) | After a single, oral dose of 75 mg, clopidogrel has a half-life of approximately 6 hours. | The active metabolite has an elimination half-life of about 7 hours (range 2-15 hours). |
| Earliest approval on file (Drugs@FDA) | November 17, 1997 | July 10, 2009 |
| First generic approved | January 14, 2008 | July 12, 2017 |
| Generic labelers (NDC) | 35 labelers | 10 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0472 per tablet (Clopidogrel 75 mg tablet) | $0.263 per tablet (Prasugrel 10 mg tablet) |
| 12-month price change | -15% | -7% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 6 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 211,001 | 12,433 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Prasugrel label, contraindicationsIn TRITON-TIMI 38 ( TR ial to Assess I mprovement in T herapeutic Outcomes by O ptimizing Platelet Inhibitio N with prasugrel), patients with a history of TIA or ischemic stroke (>3 months prior to enrollment) had a higher rate of stroke on prasugrel tablets (6.5%; of which 4.2% were thrombotic stroke and 2.3% were intracranial hemorrhage [ICH]) than on clopidogrel (1.2%; all thrombotic).
Prasugrel label, warnings and precautionsWith the dosing regimens used in TRITON-TIMI 38, TIMI (Thrombolysis in Myocardial Infarction) Major (clinically overt bleeding associated with a fall in hemoglobin ≥5 g/dL, or intracranial hemorrhage) and TIMI Minor (overt bleeding associated with a fall in hemoglobin of ≥3 g/dL but <5 g/dL) bleeding events were more common on prasugrel tablets than on clopidogrel [see Adverse Reactions (6.1)].
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Clopidogrel label, drug interactionsPromptly evaluate any signs or symptoms of blood loss if patients are treated concomitantly with other antiplatelet agents [see Warnings and Precautions (5.2) ].
Source: FDA drug labels via openFDA
What next?
- Alternatives to clopidogrel
- every medicine labeled for the same conditions