Comparative Pharmacology
Head-to-head clinical analysis: EFFIENT versus PLETAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EFFIENT versus PLETAL.
EFFIENT vs PLETAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Prasugrel is a thienopyridine prodrug that irreversibly inhibits the P2Y12 receptor on platelets, reducing ADP-mediated platelet aggregation.
Cilostazol inhibits phosphodiesterase III (PDE3), increasing cAMP levels in platelets and vascular smooth muscle, leading to platelet inhibition and vasodilation.
Loading dose: 60 mg orally once. Maintenance: 10 mg orally once daily. In patients weighing <60 kg, maintenance dose is 5 mg orally once daily.
100 mg orally twice daily, administered at least 30 minutes before or 2 hours after meals.
None Documented
None Documented
The terminal elimination half-life of the active metabolite is about 7.6 hours (range 2-15 hours). Clinically, this supports once-daily dosing.
Terminal half-life of cilostazol is approximately 11-13 hours; for active metabolites 3,4-dehydro-cilostazol (about 4-6 times more active) half-life is similar. Steady state achieved within a few days.
Approximately 68% of the dose is excreted in urine as inactive metabolites, and about 27% in feces.
Renal (approximately 77% as metabolites, <1% unchanged); fecal (approximately 18%)
Category C
Category C
Antiplatelet Agent
Antiplatelet Agent