- March 15, 2022
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Brand Name :
Plavix
Synonyms :
clopidogrel
Class :
Antiplatelet Agents, Hematologic; Platelet aggregation inhibitors
Dosage Forms & Strengths
Tablet
75mg
300mg
75
mg
Orally
every day
Tablet
Non-ST-Elevation Myocardial Infarction (NSTEMI)
Loading dose:
300
mg
Orally
every day
Tablet
Maintenance dose: 75 mg orally daily
ST-Elevation Myocardial Infarction (STEMI)
Loading dose: 300 mg orally daily
Maintenance dose: 75 mg orally daily with/without thrombolytics
Indicated for Recent MI and Stroke:
75
mg
Orally
every day
Tablet
75
mg
Orally
every day
Tablet
Not recommended
Refer adult dosing
clopidogrel: they may enhance serum concentrations of CYP2C19 Inducers
clopidogrel: they may enhance serum concentrations of CYP2C19 Inducers
clopidogrel: they may enhance serum concentrations of CYP2C19 Inducers
clopidogrel: they may enhance serum concentrations of CYP2C19 Inducers
clopidogrel: they may enhance serum concentrations of CYP2C19 Inducers
may have an increased anticoagulant effect when combined with heparin
morphine (Systemic): they may decrease the antiplatelet effect of Antiplatelet Agents (P2Y12 Inhibitors)
may enhance the concentration when combined with serum of selexipag
may enhance the concentration of serum when combined with treprostinil
dalfampridine: they may enhance the serum concentration of OCT1 Inhibitors
caplacizumab: they may increase the toxic effect of Antiplatelet agents
may increase the antiplatelet effect
pacritinib may elevate the levels of OCT1 substrates in the bloodstream, which is clinically relevant primarily when used with inhibitors
omeprazole: they may decrease the antiplatelet effect of clopidogrel
may enhance the concentration of serum when combined with CYP2C8 substrates
choline magnesium trisalicylate
may increase the risk of adverse effect of salicylates
may enhance the risk of adverse effect of thrombolytic agents
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may enhance the adverse/toxic effect of anticoagulants
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may decrease the therapeutic effect when combined with clopidogrel
may decrease the therapeutic effect when combined with clopidogrel
may decrease the therapeutic effect when combined with clopidogrel
may decrease the therapeutic effect when combined with clopidogrel
may decrease the therapeutic effect when combined with clopidogrel
choline magnesium trisalicylate
may have an increasingly adverse effect when combined with salicylates
It may enhance the risk of bleeding by affecting coagulation when combined with omega-3 carboxylic acids
may diminish the concentration of serum when combined with clopidogrel
may diminish the concentration of serum when combined with clopidogrel
Combining clopidogrel with pranlukast may cause a reduction in the clopidogrel’s metabolism
when bromazepam and clopidogrel are used together, there is a potential reduction in the bromazepam's metabolism
Combining tegafur with clopidogrel can reduce tegafur’s metabolism
when both drugs are combined, there may be an increased effect of other antiplatelet agents
it may increase the antiplatelet effect of other antiplatelets agents
may enhance the toxicity of the other through anti coagulation
may increase the antiplatelet effect of prostacyclin analogs
may increase the anti-platelet effect
may increase the anti-coagulant action of anti-coagulants
may increase the antiplatelet effect of antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may increase the antiplatelet effect of other antiplatelet agents
may have an increasingly adverse effect when combined with Cephalothin
may have an increasingly adverse effect when combined with Deoxycholic Acid
may increase the antiplatelet effect of nonsteroidal anti-inflammatory agents
may have an increased adverse effect when combined with ibritumomab tiuxetan
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the effect of anticoagulating agents
other antiplatelet agents increase the toxicity of apixaban
antiplatelet agents increase the effect of thrombolytic agents
it increases the effect of antiplatelet agents
antiplatelet agents increase the toxicity of obinutuzumab
they increase the efficacy of antiplatelet agents
it increases the efficacy of antiplatelet agents
it increases the efficacy of antiplatelet agents
it increases the toxicity of antiplatelet agents
may diminish the serum concentration when combined with CYP2C8 substrates
may enhance the concentration of serum when combined with treprostinil
may enhance the effects by pharmacodynamic synergism when combined with clopidogrel
it increases the effect of antiplatelet agents
other antiplatelet agents increase the anticoagulative effect of rivaroxaban
it increases the toxicity of antiplatelet agents
clofarabine: they may enhance the serum concentration of OCT1 Inhibitors
daprodustat: they may enhance the serum concentration of CYP2C8 Inhibitors
CYP2C8 Inhibitors: they may enhance the serum concentration of repaglinide
lipid emulsion (plant oil-based)
lipid emulsion: they may increase the toxic effect of antiplatelet agents
prostacyclin: they may increase the antiplatelet effect of antiplatelet agents
prostacyclin: they may increase the antiplatelet effect of antiplatelet agents
prostacyclin: they may increase the antiplatelet effect of antiplatelet agents
l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine
multivitamins: they may increase the antiplatelet effect of antiplatelet agents
dasatinib: they may increase the anticoagulant effect antiplatelet properties
naftazone : they may increase the antiplatelet effect of antiplatelet agents
porfimer: they may increase the toxic effect of antiplatelet agents
other antiplatelet agents increase the anticoagulative effect of enoxaparin
Action and spectrum:
clopidogrel is an antiplatelet medication that works by inhibiting the P2Y12 receptor on platelets, preventing them from clumping together and forming blood clots. It is used to prevent heart attacks and strokes in people who are at high risk for these events, such as those who have had a previous heart attack or stroke, or those with peripheral artery disease. The medication is usually taken once daily, and its effects last for the duration of the dosing interval. The standard dose is 75mg once daily. The spectrum of action of clopidogrel is limited to the inhibition of platelet aggregation.
Adverse drug reactions:
Frequency Defined
1-10%
Arthralgia
Chest pain
Dizziness
Diarrhea
Depression
Headache
Flu-like syndrome
Rash
Rhinitis
URTI
Urinary tract infection
<1%
Agranulocytosis
Acute liver failure
Hypotension
Aplastic anemia
Neutropenia
Eczema
Erythema
Thrombocytopenic purpura
Hepatitis
Myalgia
Post-marketing reports
Agranulocytosis
Pancreatitis
Stomatitis
Aplastic anemia
Abnormal liver function test
Serum sickness
Gastro-duodenal ulcer
Acute liver failure
Pancytopenia
Acquired hemophilia A
Colitis
Hepatitis
Black box warning:
The black box warning for clopidogrel, a medication used to prevent blood clots, states that the drug can cause serious bleeding and that it should be used with caution in patients who have a history of bleeding or are at high risk for bleeding.
Contraindication / Caution:
Contraindications:
Cautions:
Pregnancy warnings:
AU TGA pregnancy category: B1
US FDA pregnancy category: Not Assigned
Lactation:
Excreted into human milk is unknown
Pregnancy Categories:
Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester.
Category B: No evidence shown of risk to the fetus found in animal reproduction studies, and there are not enough studies on pregnant women
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a result in humans must take care of potential risks in pregnant women
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.
Category N: There is no data available for the drug under this category
Pharmacology:
clopidogrel is a medication that belongs to a class of drugs known as antiplatelet agents.
Pharmacodynamics:
It works by inhibiting the action of the enzyme cyclooxygenase (COX), which is responsible for the production of thromboxane A2 (TXA2). TXA2 is a substance that promotes the formation of blood clots.
When clopidogrel is taken, it blocks the COX enzyme and prevents the formation of TXA2. This results in a reduction in the number of platelets that clump together, which reduces the risk of blood clots forming.
Pharmacokinetics:
Absorption
clopidogrel is rapidly and completely absorbed after oral administration. The bioavailability of clopidogrel is approximately 50%.
Distribution
It is widely distributed in the body, with a volume of distribution of approximately 17 L/kg. It binds to plasma proteins to a moderate extent, with a binding rate of approximately 40%.
Metabolism
clopidogrel is metabolized by the liver, primarily through the action of cytochrome P450 (CYP) isoenzymes. The major metabolite is an inactive carboxylic acid derivative.
Elimination and Excretion
clopidogrel is excreted primarily in the urine, with a small portion excreted in the feces. The elimination half-life of clopidogrel is approximately 6 hours
Administration:
Oral administration
clopidogrel is typically administered orally, usually once daily. The dosage may vary depending on the individual’s medical condition and response to treatment. It is important to take the medication exactly as prescribed by the healthcare provider and to not make any changes to the dosage or frequency without consulting a doctor.
clopidogrel should be taken with a full glass of water, either with or without food. If a dose is missed, it should be taken as soon as possible, unless it is close to the time for the next dose.
Patient Information Leaflet
Generic Name: clopidogrel
Why do we use clopidogrel?
clopidogrel is a medication that is used to prevent blood clots in individuals who have had a heart attack, stroke, or other serious cardiovascular events. It works by preventing platelets in the blood from sticking together and forming clots, which can block blood flow to the heart and brain. clopidogrel is typically taken as a daily oral tablet and is often prescribed in combination with other medications such as aspirin.
