Clopidogrel

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General

  • Type: Antiplatelet
  • Dosage Forms: 75, 300 PO
  • Common Trade Names: Plavix

Adult Dosing

Age and Indication Related Dosages[1][2][3]

Trial Age < 75 Age > 75
STEMI with fibrinolysis CLARITY 300 mg 75 mg
STEMI with PCI OASIS-7 600 mg 300 mg
NSTEMI/UA with ischemic EKG changes CURE 300 mg 75 mg

Post-Acute coronary syndrome

Thrombotic event prevention

  • 75mg PO QD

Pediatric Dosing

  • Not Recommended

Special Populations

  • Pregnancy Rating: B
  • Lactation: Safety Unknown
  • Renal Dosing
    • Adult: not defined
    • Pediatric
  • Hepatic Dosing
    • Adult: no adjustment
    • Pediatric

Contraindications

  • Allergy to class/drug
  • active bleeding
  • caution if trauma
  • caution if elective surgery within 5 days
  • caution if GI disorder
  • caution if ocular disease
  • caution if poor or intermediate CYP2C19 metabolizer
  • caution if renal impairment, mod-severe

Adverse Reactions

Serious

Common

  • bleeding
  • pruritus

Pharmacology

  • Half-life: 8h
  • Metabolism: liver, CYP450: 1A2, 2C9, 2C19 (primary), 3A4 substrate
  • Excretion: urine 50%, feces 46%
  • Mechanism of Action: irreversibly binds to P2Y12 adenosine diphosphate receptors, reducing platelet activation and aggregation

See Also

References

  1. Sabatine MS et al. Addition of Clopidogrel to Aspirin and Fibrinolytic Therapy for Myocardial Infarction with ST-Segment Elevation. N Engl J Med 2005; 352:1179-1189.
  2. Mehta SR et al. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet. 2010 Oct 9;376(9748):1233-43.
  3. The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-Segment Elevation. N Engl J Med 2001; 345:494-502.