Which P2Y12 inhibitor is available only intravenously?

• A. Cangrelor
• B. Clopidogrel
• C. Prasugrel
• D. Ticagrelor

Answer: (A)

P2Y12 inhibition works best when you match the agent to how quickly you need platelet blockade and how quickly you can adjust it. Cangrelor is the only P2Y12 inhibitor given by intravenous infusion, providing immediate platelet inhibition as soon as it’s started. Its effect wears off rapidly—platelet function returns to baseline within about an hour after the infusion ends—so you can easily bridge to oral therapy or halt bleeding if needed. This IV option is specifically useful during PCI when rapid, controllable antiplatelet action is crucial.

The other agents are all taken by mouth. Clopidogrel and prasugrel are prodrugs that require metabolic activation and have slower onset, which isn’t ideal when you need immediate effect. Ticagrelor is oral and while it has a quick onset compared with clopidogrel, it is still not IV.