Clopidogrel

Anticoagulant/Antiplatelet · Antiplatelet

Indications

Prevention of atherothrombotic events in patients suffering from myocardial infarction (from a few days until less than 35 days), ischaemic stroke (from day 7 until less than 6 months) or established peripheral artery disease. In combination with aspirin in non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-Wave MI.

Dosage

Adults: 75 mg daily with or without food. Non-ST segment elevation acute coronary syndrome: Adults: 300 mg loading dose followed by 75 mg daily given in combination with 75-100 mg aspirin daily. Children: Not recommended.

Adverse Effects

Bleeding episodes, GI upset, haematoma, skin reactions. Nervous system, hepatic, biliary or haematological disorders. Rarely, thrombotic thrombocytopenic purpura. Stevens-Johnson syndrome.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe hepatic impairment, active bleeding such as peptic ulcer or intracranial haemorrhage. Do not initiate therapy within first few days after MI. PTCA (stenting), CABG and acute ischaemic stroke of less than 7 days. Precautions: Renal impairment, moderate hepatic impairment. Surgery. Risk of bleeding and blood dyscrasias; perform blood counts promptly if suspected and when used with other drugs or conditions that affect bleeding. Warn patients to report unusual bleeding. Risk of acquired haemophilia; discontinue if confirmed.

Interactions

Anticoagulants, glycoprotein IIb/IIIa inhibitors, thrombolytics, NSAIDs, SSRIs, pentoxifylline, PPIs and other moderate or strong CYP2C19 inhibitors. CYP2C8 substrates (e.g., repaglinide)

Advice to Patient

Take with or without meals. Inform physician or dentist about this medication before having any surgery or dental procedure. Contact prescriber immediately if there is unusual or acute chest pain or respiratory difficulties, skin rash, unresolved bleeding, diarrhoea, GI discomfort, nosebleed or acute headache. Do not use NSAIDS including OTC medications during clopidogrel therapy.

Pharmacokinetics

Onset of action: Inhibition of platelet aggregation (IPA): Dose-dependant: 300-600 mg loading dose: Detected within 2 hrs. 50-100 mg/day: Detected by the second day of treatment. Peak effect: Time to maximal IPA: Dose-dependant: Degree of IPA based on adenosine diphosphate (ADP) conc used during light aggregometry. 300-600 mg loading dose: ADP 5 micromole/L: 20%-30% IPA at 6 hrs post administration. ADP 20 micromole/L: 30%-37% IPA at 6 hrs post administration. 50-100 mg/day: ADP 5 micromole/L: 50%-60% IPA at 5-7 days. Duration of action: Approx. 5 days after discontinuation. Absorption: Rapid, well absorbed. Metabolism: Extensively hepatic. Half-life elimination: Parent drug: Approx. 6 hrs. Time to peak, serum: Approx. 0.75 hrs. Excretion: Urine (50%). Faeces (46%).

Brands with this active ingredient

• Abiclot
• Agranil
• Alfagrel
• Ateplex
• Clopid
• Clopido
• Clopidob
• Clopidro
• Clopinext
• Clopix
• Clotinil
• Clotles
• Clotnil
• Cloxidil
• Cocard

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.