Table 1.

Comparative properties involving oral P2Y12 inhibitors.

	Clopidogrel	Prasugrel	Ticagrelor
Binding	Irreversible	Irreversible	Reversible
Onset of action	2–6 h	30 min	30 min
Half-life of active metabolite	30–60 min	30–60 min (distribution) 2–15 h (elimination)	7–9 h
Duration of effect	3–10 days	7–10 days	3–5 days
Frequency of administration	Once daily	Once daily	Twice daily
Discontinuation prior to non-acute surgery	At least 5 days	At least 7 days	At least 3 days

N/A = not applicable. In patients with ACS previously exposed to clopidogrel, switching to ticagrelor is recommended early after hospital admission at a loading dose of 180 mg irrespective of timing and loading dose of clopidogrel, unless contraindicated (IB). All other switching between P2Y12 inhibitors may be considered in cases of side effects/intolerance (IIb-C) [3].