I am sorry to hear you are having problems with SQL Prompt.
Can you try adding the path (by default: C:\\Program Files (x86)\\Red Gate\\SQL Prompt 4) manually in Visual Studio. You can do that by navigating to Tools –> options –> add-in/macros security and add the SQL Prompt add-in. Ensure that Tools>Add-in Manager "Include SQL Prompt at startup" is checked then restart the Visual Studio.
If this doesn't work, then try re-registering the DLL:
1. Open a command prompt, change the directory to the SQL Prompt installation folder. Run
%SYSTEMROOT%\\Microsoft.net\\Framework\\v2.0.50727\\regasm "%ProgramFiles%\\Red Gate\\SQL Prompt 4\\RedGate.SQLPrompt.VSUI.dll"
2. Run devenv /ResetSettings in Run window.
Kindly let me know if this fixes the issue.
Note: We have a fix for the SQL Refactor not working with SQL 2008 R2 CTP kindly download the latest version from here