Clopidogrel	Prasugrel	Ticagrelor
Dosing
150 – 600 mg loading 75 mg OD	10 mg OD 5 mg OD if:   Age > 75   Weight ≥ 60 kg	180 mg loading 90 mg BID
Required Metabolic Activation
Yes sensitive to CYP2C19 polymorphisms	Yes less sensitive to CYP2C19 polymorphisms	No
Indications
ACS, PCI, PAD, CVD	ACS treated with PCI	ACS, PCI or medical treatment
Reversible Inhibition
No	No	Yes
Efficacy
++ Further 2% ARR over ASA monotherapy	+++ Further 2% ARR over clopidogrel + ASA	+++ Further 2% ARR over clopidogrel + ASA Reduced total mortality over clopidogrel + ASA
Bleeding Risk
+	+++	++
Issues
Rash	Bleeding risk in: Age > 75 Weight < 60 kg Increased fatal bleeding contraindicated with history of stroke or TIA	Dyspnea Ventricular pause Hyperuricemia Slight increased Cr