For prasugrel use in adults 75 years or older, what dosing consideration does Beers Criteria suggest?

• A. Consider a lower dose (5 mg) for those 75 and older
• B. Increase to 10 mg for faster effect
• C. Avoid prasugrel entirely in all 75+ adults
• D. No dose adjustment is necessary regardless of age

Answer: (A)

Older adults have a higher risk of bleeding with antiplatelet drugs, so Beers Criteria guides adjustments to reduce harm while preserving some protective effect. Prasugrel is effective but increases bleeding risk, and in people 75 years and older the recommended approach is to lower the maintenance dose to 5 mg daily rather than using the standard 10 mg. This dose reduction best balances benefit and safety in the elderly. Increasing to 10 mg would raise bleeding risk, and avoiding prasugrel entirely in all 75+ individuals is not what the guideline suggests. There is also no need for the dose to remain the same regardless of age, since age-related risk prompts this adjustment.