Two medicines, side by side
Ticagrelor vs prasugrel
Ticagrelor and prasugrel are both labeled for heart attack and coronary artery disease. Drugs@FDA records approvals of ticagrelor since 2011 and of prasugrel since 2009. Pharmacies paid $0.253 per ticagrelor 90 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: Ticagrelor, “Ticagrelor and its major metabolite reversibly interact with the platelet P2Y 12 ADP-receptor to prevent signal transduction and platelet activation.”; 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 ticagrelor FDA label on DailyMed (effective May 7, 2026); the prasugrel FDA label on DailyMed (effective February 11, 2025).
Highlights of the ticagrelor record
Ticagrelor (Brilinta) · label of May 7, 2026
BLEEDING RISK
BRILINTA, like other antiplatelet agents, can cause significant, sometimes fatal bleeding ( 5.1 , 6.1 ).
Do not use BRILINTA in patients with active pathological bleeding or a history of intracranial hemorrhage
( 4.1 , 4.2 ).
Do not start BRILINTA in patients undergoing urgent coronary artery bypass graft surgery (CABG) ( 5.1 ,
6.1 ).
If possible, manage bleeding without discontinuing BRILINTA.
Used for
From the label: indicationsBRILINTA is a P2Y 12 platelet inhibitor indicated • to reduce the risk of cardiovascular (CV) death, myocardial infarction (MI), and stroke in patients with acute coronary syndrome (ACS) or a history of MI. For at least the first 12 months following ACS, it is superior to clopidogrel. BRILINTA also reduces the risk of stent thrombosis in patients who have been stented for treatment of ACS. […]
On the market
- Earliest approval on file
- July 20, 2011
- Generic labelers
- 28 labelers
- Pharmacy cost
- $0.253 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
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 (Ticagrelor label of May 7, 2026, Prasugrel label of February 11, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do ticagrelor and prasugrel differ on the record?
How each works, in its label's words: Ticagrelor, “Ticagrelor and its major metabolite reversibly interact with the platelet P2Y 12 ADP-receptor to prevent signal transduction and platelet activation.”; 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.
Both labels carry a boxed warning; the records quote them.
Generics: ticagrelor since 2018; prasugrel since 2017 (Drugs@FDA).
| Ticagrelor | Prasugrel | |
|---|---|---|
| Labeled for | Heart attack and coronary artery disease, Stroke prevention | Heart attack and coronary artery disease, Angina |
| Pharmacologic class | P2Y12 Platelet Inhibitor | P2Y12 Platelet Inhibitor |
| How it works (label) | Ticagrelor and its major metabolite reversibly interact with the platelet P2Y 12 ADP-receptor to prevent signal transduction and platelet activation. Ticagrelor and its active metabolite are approximately equipotent. | 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) | n/a | The active metabolite has an elimination half-life of about 7 hours (range 2-15 hours). |
| Earliest approval on file (Drugs@FDA) | July 20, 2011 | July 10, 2009 |
| First generic approved | September 4, 2018 | July 12, 2017 |
| Generic labelers (NDC) | 28 labelers | 10 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.253 per tablet (Ticagrelor 90 mg tablet) | $0.263 per tablet (Prasugrel 10 mg tablet) |
| 12-month price change | -43% | -7% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 31,712 | 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)
What next?
- Alternatives to ticagrelor
- every medicine labeled for the same conditions