Clopidogrel

Clopidogrel may show a delayed onset of platelet inhibition of 48 h because it requires activation by two-stage hepatic metabolism.

About : Always check the BNF link here

• Thienopyridine platelet antagonist P2Y₁₂ receptor blocker
• Ask cardiologist before stopping dual antiplatelet early post stenting.

Action

• Blocks platelet activation and works synergistically with Aspirin
• Genetic variations in metabolism

Mode of action

• Prodrug which requires activation in the liver
• Clopidogrel blocks the activation of the platelet P2Y12 receptor - antiplatelet agent
• Selective and irreversible inhibition of ADP binding to platelet receptors
• Prolongs the bleeding time

Indications

• NSTEMI (CURE study) treat for up to 1 year
• STEMI (CLARITY study and COMMIT study) for 14 days
• PCI patients (CLASSICS trial and PCI CURE)
• Bare metal stent - at least one month Treatment
• Drug eluting stent - 12 months Aspirin + Clopidogrel treatment
• Aspirin intolerant patients requiring antiplatelet therapy

Contraindications

• Bleeding 1% increased risk of major bleeds
• Trauma, imminent surgery, Thrombocytopenia

interactions

• Effects reduced by omeprazole

Dose

Side effects

• Diarrhoea, Rash, Dyspepsia, Bleeding takes 7 days for the effect to reduce.

References

• Summary Product Characteristics