Effient is a P2Y12 platelet inhibitor indicated for the reduction of thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndrome who are to be managed with PCI as follows:
• Patients with unstable angina or, non-ST-elevation myocardial infarction (NSTEMI) .
• Patients with ST-elevation myocardial infarction (STEMI) when managed with either primary or delayed PCI.

Bleeding, including life-threatening and fatal bleeding, is the most commonly reported adverse reaction.

• Warfarin – Coadministration of Effient and warfarin increases the risk of bleeding [see Warnings and Precautions and Clinical Pharmacology.
• Non-Steroidal Anti-Inflammatory Drugs
  Coadministration of Effient and NSAIDs (used chronically) may increase the risk of bleeding
• Other Concomitant Medications
  Effient can be administered with drugs that are inducers or inhibitors of cytochrome P450 enzymes. Effient can be administered with aspirin (75 mg to 325 mg per day), heparin, GPIIb/IIIa inhibitors, statins, digoxin, and drugs that elevate gastric pH, including proton pump inhibitors and H2 blockers.

• CABG-related bleeding: Risk increases in patients receiving Effient who undergo CABG.
• Discontinuation of Effient: Premature discontinuation increases risk of stent thrombosis, MI, and death.
• Thrombotic thrombocytopenic purpura (TTP): TTP has been reported with Effient.