prasugrel vs ticagrelor
Side-by-side comparison of prasugrel and ticagrelor Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
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Prasugrel is a drug that helps prevent blood clots. It is used to lower the risk of heart attack, stroke, and blood clots in people with acute coronary syndrome who are undergoing a procedure called percutaneous coronary intervention (PCI).
Ticagrelor is a drug that helps to prevent blood clots. It is used to lower your risk of heart attack, stroke, and death if you have heart problems.
Prasugrel helps prevent dangerous blood clots if you have acute coronary syndrome. This includes unstable angina (chest pain) or a heart attack. It is for people who will have a procedure to open blocked arteries, called percutaneous coronary intervention (PCI). Prasugrel can lower your chance of heart attack, stroke, or death.
Ticagrelor is used to lower the risk of heart attack, stroke, and cardiovascular death. It is for people who have had a heart problem like acute coronary syndrome (ACS) or a heart attack (MI). It can also help prevent blood clots from forming in stents after a stent procedure. Ticagrelor can also reduce the risk of stroke in patients with acute ischemic stroke or high-risk transient ischemic attack (TIA).
Prasugrel belongs to a class of drugs called P2Y12 inhibitors. It works by blocking a substance in your blood called ADP. By blocking ADP, prasugrel helps prevent platelets (blood cells that cause clotting) from sticking together and forming unwanted blood clots.
Ticagrelor is a P2Y12 inhibitor. This means it blocks a substance in your blood called P2Y12. By blocking P2Y12, ticagrelor helps prevent platelets from sticking together and forming blood clots.
- • Bleeding
- • Bleeding
- • Shortness of breath
- Heart attack 172
- Drug not working 106
- Shortness of breath 106
- Sudden heart attack 102
- Using the drug for a non-approved purpose 93
- Shortness of breath 3,952
- Heart attack 2,741
- Death 1,714
- Tiredness 1,525
- Using the medicine for something it's not approved for 1,502
Prasugrel can cause serious bleeding, which can sometimes be fatal. You should not take this medicine if you have active bleeding or have had a stroke or transient ischemic attack (TIA). If you are 75 or older, prasugrel is generally not recommended due to the increased risk of bleeding, unless you have diabetes or have had a prior heart attack. Do not start prasugrel if you are likely to need urgent heart bypass surgery (CABG). If possible, stop taking prasugrel at least 7 days before any surgery. Other things that raise your bleeding risk are: body weight under 60 kg, a tendency to bleed easily, and taking other medicines that increase bleeding risk. If you have low blood pressure and recently had a heart procedure or surgery, suspect bleeding. If possible, manage bleeding without stopping prasugrel, because stopping it can raise your risk of heart problems.
Ticagrelor can cause serious bleeding, which can sometimes be fatal. You should not take this medicine if you have active bleeding or a history of bleeding in the brain. Do not start ticagrelor if you are going to have urgent heart bypass surgery (CABG). If possible, manage any bleeding without stopping ticagrelor. Stopping ticagrelor can increase your risk of heart problems.
There is not enough information about the safety of prasugrel during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant. It is not known if prasugrel passes into breast milk, so talk to your doctor about the risks and benefits of breastfeeding while taking this medicine.
Tell your doctor if you are pregnant or plan to become pregnant. Animal studies suggest a risk to the fetus. Breastfeeding is not recommended while taking ticagrelor.
How to Read This prasugrel vs ticagrelor Comparison
prasugrel is classified in the P2Y12 Inhibitor (Antiplatelet) drug class, while ticagrelor sits within the P2Y12 Inhibitor (Antiplatelet) class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, prasugrel has 579 submissions while ticagrelor has 11,434. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between prasugrel and ticagrelor — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.