Agent	Drug classification	Onset of action	Adverse effects	Maintenance dose per day*	Duration of therapy	Perioperative considerations	Contraindications	Common medication interactions
Aspirin	Cyclooxygenase-1 inhibitor	< 1 hour without enteric coating 3 to 4 hours with enteric coating	Bleeding, gastrointestinal ulcers	81 mg	Ongoing	Continue medication	Aspirin allergy; consider providing desensitization	ACE inhibitors, anticoagulants, CCBs (nondihydropyridine), loop diuretics, multi-vitamins, NSAIDs, SSRIs, steroids
Clopidogrel	P2Y12 inhibitor	2 to 4 hours	Bleeding, rash, diarrhea	75 mg	1 year†	Hold 5 days before surgery	Severe bleeding	Anticoagulants, bupropion, CCBs, morphine, multivitamins, NSAIDs, PPIs, P2Y12 inhibitors, SSRIs
Prasugrel (Effient)	P2Y12 inhibitor	30 to 60 minutes	Bleeding, hypertension, headache	10 mg	1 year†	Hold 7 days before surgery	History of stroke or transient ischemic attack	Anticoagulants, multivitamins, NSAIDs, P2Y12 inhibitors, SSRIs
Ticagrelor (Brilinta)	P2Y12 inhibitor	30 minutes	Bleeding, bradyarrhythmia, dyspnea	90 mg twice daily	1 year†	Hold 5 days before surgery	Use with caution in patients with baseline dyspnea	Anticoagulants, multivitamins, NSAIDs, P2Y12 inhibitors, statins, SSRIs