Table 1.

Antiplatelet agents, mechanism of action and response to agonists used in platelet function testing (19,6467)

Drug (Type)ActionMean Platelet Inhibition (Time Required)Response to Collagen/AAResponse to ADPDosing in CKD and ESRD (68)
Aspirin (NSAIDs)Inhibits COX-1<30 minInhibitsNoneUse with caution eGFR <10 ml/min per 1.73 m2
Clopidogrel (Thienopyridine)Inhibits P2Y12 receptor<1 h with loading dose of 300 mg; 2–3 d for daily dose of 75 mgNoInhibitsNo dose adjustment required
Prasugrel (Thienopyridine)Inhibits P2Y12 receptor2–4 hNoInhibitsNo dose adjustment required; no data in ESRD available
Ticagrelor (ATP analog)Inhibits P2Y12 receptor2–4 hNoInhibitsNo dose adjustment required; no data in ESRD available
Dipyridamole (PDE inhibitor)Increases platelet cAMPVariableVariableInhibits in whole blood not in platelet-rich plasmaNo dose adjustment required
Cilostazol (PDE inhibitor)Increases platelet cAMPVariableInhibitsInhibitsNo dose adjustment required; caution advised for creatinine clearance <25 ml/min
  • NSAIDs, nonsteroidal anti-inflammatory agents; COX-1, cycloxygenase-1; eGFR, estimated GFR; PDE, phosphodiesterase; cAMP, cyclic AMP.