title: Prasugrel as an alternative for clopidogrel-associated neutropenia.
abstract: Clopidogrel has mostly replaced the use of ticlopidine due to its more favourable hematologic adverse event profile. Prasugrel is the newest thienopyridine approved for use in Canada. This case describes a patient who was diagnosed with an acute coronary syndrome and treated with bare metal stenting of his coronary artery. He was discharged home on clopidogrel therapy. Two weeks later he presented with severe neutropenia. Clopidogrel was discontinued and prasugrel was initiated. Neutrophil count gradually increased and returned to normal. In patients with neutropenia associated with clopidogrel therapy, prasugrel may be considered as an alternative.
authors.affiliation: Department of Pharmacy, Royal Columbian Hospital, Fraser Health, New Westminster, British Columbia, Canada. sanjiv.khangura@fraserhealth.ca
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Khangura
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Gordon
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000601:surgery*; D000369:Aged, 80 and over; D000077144:Clopidogrel; D001026:Coronary Artery Bypass / Q000379:methods*; D023903:Coronary Restenosis / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control; D010879:Piperazines / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D000068799:Prasugrel Hydrochloride; D058921:Purinergic P2Y Receptor Antagonists / Q000008:administration & dosage*; D015607:Stents; D013876:Thiophenes / Q000008:administration & dosage*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D058921:Purinergic P2Y Receptor Antagonists; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D013988:Ticlopidine