Table 1. . List of antiplatelet medications along with their mechanism and forms of metabolism.
| Drug | Route | Mechanism of action | Metabolism |
|---|---|---|---|
| Aspirin | Oral | COX inhibitor, nonselective | Hydrolysis by tissue esterases |
| Cilostazol (Pletal) | Oral | Phosphodiesterase III inhibitor | Oxidation by CYP3A4 (major) and CYP2C19 (minor) |
| Dipyridamole (Persantine and Aggrenox) | Oral | Adenosine uptake inhibitor; phosphodiesterase inhibitor | Glucuronidation |
| Ticlopidine (Ticlid) | Oral | P2Y12 inhibitor (irreversible) | N-dealkylation and oxidation |
| Clopidogrel (Plavix) | Oral | P2Y12 inhibitor (irreversible) | Oxidation by CYP2C19 (major)†, CYP3A (minor), CYP2B6 (minor) |
| Prasugrel (Effient) | Oral | P2Y12 inhibitor (irreversible) | Oxidation by CYP3A4 (major) CYP2B6 (major), CYP2C9 (minor), CYP2C19 (minor) |
| Ticagrelor (Brillinta) | Oral | P2Y12 inhibitor (reversible) | Oxidation by CYP3A4 |
| Cangrelor (Kengreal) | IV | P2Y12 inhibitor (reversible) | Dephosphorylation |
| Eptifibatide (Integrilin) | IV | Glycoprotein IIb/IIIa inhibitor (reversible) | None |
| Abciximab (Reopro) | IV | Glycoprotein IIb/IIIa inhibitor (irreversible) | Proteolytic cleavage |
| Tirofiban (Aggrastat) | IV | Glycoprotein IIb/IIIa inhibitor (reversible) | None |
†
Primary mechanism for bioactivation.
IV: Intravenous.