{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T03:21:19Z","timestamp":1770780079161,"version":"3.50.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>An adverse drug reaction associated with the use of prasugrel for dual antiplatelet therapy after percutaneous coronary intervention (PCI) with stent placement is reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>About one week after starting prasugrel use following angioplasty and a stent revision procedure, a 61-year-old woman arrived in the emergency department with wheezing, shortness of breath, a feeling of throat closure, and a widespread erythematous, maculopapular, pruritic rash. She reported that the respiratory symptoms had started to develop the previous day, with the onset of rash occurring about 24 hours after initiation of prasugrel therapy. The patient\u2019s symptoms subsided after administration of 0.3 mg epinephrine subcutaneously, diphenhydramine 50 mg i.v., and methylprednisolone 125 mg i.v. Prasugrel was discontinued, and the patient was switched to another P2Y12 inhibitor (ticagrelor) for continued dual antiplatelet therapy. Analysis of the case using the adverse drug reaction probability scale of Naranjo et al. indicated that prasugrel was the probable cause of the hypersensitivity reaction. Hypersensitivity manifesting as a rash has been previously reported in patients receiving prasugrel, a thienopyridine P2Y12 inhibitor. Desensitization may be an option for thienopyridine-allergic patients undergoing PCI with stenting; alternatively, the nonthienopyridine P2Y12 inhibitor ticagrelor may be used in a dual antiplatelet therapy regimen.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A patient who had undergone PCI with stenting developed shortness of breath and rash associated with prasugrel therapy. Symptoms abated after supportive therapy and discontinuation of prasugrel, the probable offending agent. Treatment was safely switched to ticagrelor.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2146\/ajhp150327","type":"journal-article","created":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T10:08:18Z","timestamp":1467799698000},"page":"1051-1057","source":"Crossref","is-referenced-by-count":6,"title":["Prasugrel hypersensitivity with respiratory distress and rash"],"prefix":"10.1093","volume":"73","author":[{"given":"Michele B.","family":"Kaufman","sequence":"first","affiliation":[{"name":"NewYork-Presbyterian Hospital, Lower Manhattan Pharmacy Department, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tammy","family":"Pham","sequence":"additional","affiliation":[{"name":"St. Anthony\u2019s Hospital, St. Petersburg, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalitha","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Weill Cornell Medical College, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Choy","sequence":"additional","affiliation":[{"name":"Metropolitan Hospital, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"2020071622113759000_b1-0731051","first-page":"e344","article-title":"2014 AHA\/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"130","author":"Amsterdam","year":"2014","journal-title":"Circulation"},{"key":"2020071622113759000_b2-0731051","volume-title":"Effient (prasugrel) package insert","year":"2013"},{"key":"2020071622113759000_b3-0731051","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1016\/j.jacc.2007.08.016","article-title":"Clopidogrel desensitization after drug-eluting stent placement","volume":"50","author":"Von Tiehl","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2020071622113759000_b4-0731051","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1016\/j.jacc.2011.06.040","article-title":"Characterization of clopidogrel hypersensitivity reactions and management with oral steroids without clopidogrel discontinuation","volume":"58","author":"Cheema","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2020071622113759000_b5-0731051","doi-asserted-by":"crossref","first-page":"4381","DOI":"10.1016\/j.ijcard.2013.05.051","article-title":"A strategy of \u2018treating through\u2019 a prasugrel-induced rash","volume":"168","author":"Yang","year":"2013","journal-title":"Int J Cardiol"},{"key":"2020071622113759000_b6-0731051","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1345\/aph.1R062","article-title":"Prasugrel-induced rash","volume":"46","author":"Deshmukh","year":"2012","journal-title":"Ann Pharmacother"},{"key":"2020071622113759000_b7-0731051","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1016\/j.ijcard.2011.09.051","article-title":"Allergic reaction to prasugrel and cross-reactivity with clopidogrel","volume":"157","author":"Raccah","year":"2012","journal-title":"Int J Cardiol"},{"key":"2020071622113759000_b8-0731051","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.anai.2011.11.005","article-title":"Desensitization to prasugrel: cardiology\u2019s increased need for allergy consultation","volume":"108","author":"Mutnick","year":"2012","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2020071622113759000_b9-0731051","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.recesp.2011.11.011","article-title":"Management of a hypersensitivity reaction to thienopyridines: prasugrel-induced fever and hepatitis resolved after switching to clopidogrel","volume":"65","author":"Fern\u00e1ndez-Ruiz","year":"2012","journal-title":"Rev Esp Cardiol"},{"key":"2020071622113759000_b10-0731051","unstructured":"Medicines and Healthcare Products Regulatory Agency. 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