CLOPIDOGREL (Plavix): What is used for?

What is Clopidogrel?

Clopidogrel is an active ingredient used for the prevention of atherothrombotic and thromboembolic events (acute myocardial infarction, cerebral infarction, etc.).
The product ingredients are: Clopidogrel besilate, Clopidogrel bisulfate and Clopidogrel hydrochloride (hcl).

The brand name of Clopidogrel in United States is Plavix.

Clopidogrel Mechanism of Action (MOA)

A drug that inhibits platelet aggregation by inhibiting the binding of ADP to its platelet receptor and the subsequent activation of the ADP-mediated GPIIb-IIIa complex.

Therapeutic Indications, Uses, Benefits and Dosage of Clopidogrel

Oral.

Adults:

Prevention of aterothrombotic events in:

  1. Patients who have recently suffered a myocardial infarction (from a few days before to a maximum of 35 days), cerebral infarction (from 7 days before to a maximum of 6 months) or suffer from established peripheral arterial disease: 75 mg/24 hours.
  2. Patients with acute coronary syndrome:
  • Non-ST segment elevation acute coronary syndrome (unstable angina or myocardial infarction without Q wave), including patients undergoing stenting after percutaneous coronary intervention, combined with AAS: loading dose, 300 mg; continue with 75 mg/24 hours (+ 75-325 mg/24 hours of AAS).
    Maximum 12 months.
  • Acute myocardial infarction with ST segment elevation, which are candidates for thrombolytic therapy, in combination with AAS: start with load dose, 300 mg + AAS, with or without thrombolytics; continue with 75 mg/24 hours, minimum 4 weeks.
    Older than 75 years: start without load dose.

Prevention of atherothrombotic and thromboembolic events, including stroke, in adults with atrial fibrillation who have at least one risk factor for vascular events, who are not eligible for treatment with vitamin K antagonists and who have a low bleeding rate, in combination with AAS: 75 mg/24 hours (+ 75-100 mg/24 hours of AAS).

Method of administration

Oral use.
Single daily dose with or without food.

Tablet:

  • 75 mg/1
  • 300 mg/1

Contraindications of Clopidogrel

  • Hypersensitivity.
  • Severe liver failure.
  • Active pathologic bleeding (eg, peptic ulcer or intracranial hemorrhage).

Warnings and Precautions with Clopidogrel

  • Patients at risk of bleeding due to trauma, surgery, gastrointestinal or intraocular lesions, etc.
  • Increases the risk of bleeding administered along with: AAS, heparin, glycoprotein IIb/IIIa inhibitors, NSAIDs, SSRIs, other drugs such as pentoxifylline, thrombolytics, oral anticoagulants.
  • Suspend 7 days before surgery.
  • Risk of: thrombotic thrombocytopenic purpura (fatal), haemophilia acquired after clopidogrel administration (discontinue treatment), allergic cross-reactivity (assess if there is a history of hypersensitivity to thienopyridines and monitor during treatment.
  • Kidney failure.
  • Moderate hepatic insufficiency.
  • Do not use in children or adolescents.
  • It is not recommended during the 7 days after suffering an acute ischemic cerebral infarction.
  • Concomitant treatment with CYP2C8 substrates (e.g. repaglinide, paclitaxel).

Liver failure

Contraindicated in severe liver failure.
Caution in moderate hepatic insufficiency, due to haemorrhagic diathesis.

Renal insufficiency

Caution due to lack of experience.

Interactions with Clopidogrel

  • Not recommended with: potent or moderate inhibitors of CYP2C19 (omeprazole, esomeprazole, fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, carbamazepine, efavirenz, ritonavir and cobicistat) as they may result in reduced levels of the active clopidogrel metabolite.
  • Concomitant use of this active ingredient with pharmacokinetic enhancers of antiretroviral therapy is discouraged.

Pregnancy and Clopidogrel

Due to lack of data we do not recommend its administration.

Breastfeeding

It is not known whether clopidogrel is excreted in human breast milk. Animal studies have shown that this active ingredient is excreted in breast milk.
As a precaution, breast-feeding should be stopped during clopidogrel treatment.

Adverse reactions and side effects of Clopidogrel

  • Hematoma.
  • Epistaxis.
  • Gastrointestinal bleeding.
  • Diarrhea.
  • Abdominal pain.
  • Dyspepsia.
  • Bleeding instead of injection.

⭐⭐⭐⭐⭐ VIDEO OF CLOPIDOGREL/ PLAVIX (DRUG)

Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).

In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.

Resources:

UNII: A74586SNO7
ChemIDplus
DrugPortal
PubChem CID: 60606
NCI Thesaurus: C61686

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