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Clopidogrel information from DrugsUpdate  

See Available Brands of Clopidogrel in India

P - Caution when used during pregnancy
L - Contraindicated in lactation

Clopidogrel is an oral antiplatelet agent (thienopyridine class) to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. It is marketed by Bristol-Myers Squibb and Sanofi-Aventis under the trade name Plavix, by Sun Pharmaceuticals under the trade name Clopilet, by Ranbaxy Laboratories under the trade name Ceruvin, and under the name "Clavix" by Intas Pharmaceuticals. It works by irreversibly inhibiting a receptor called P2Y12. Adverse effects include hemorrhage.

Pharmacodynamics

Pharmacokinetics

Clopidogrel inhibits adenosine diphosphate (ADP) from binding to its receptor sites on the platelets and subsequent activation of glycoprotein GP IIb/IIIa complex thus preventing fibrinogen binding, platelet adhesion and aggregation.


Absorption
Rapidly but incompletely absorbed from the GI tract (oral).

Distribution
Protein-binding: Extensive.

Metabolism
Hepatic: Extensive; converted to inactive carboxylic acid derivative and thiol derivative (active).

Excretion
Via urine and faeces (as metabolites and unchanged drug).

Clopidogrel Indications / Clopidogrel Uses

Information Not Available

Clopidogrel Adverse Reactions / Clopidogrel Side Effects

Dyspepsia, abdominal pain, nausea, vomiting, flatulence, constipation, gastritis, gastric and duodenal ulcers. GI upset, diarrhoea, paraesthesia, vertigo, headache, dizziness, pruritus and rashes.


Potentially Fatal: Bleeding disorders including GI and intracranial haemorrhage. Blood dyscrasias.

Precautions

Information Not Available

Special Precautions

Patients at risk of increased bleeding from trauma, surgery, or other pathological conditions; ulcer; renal and hepatic impairment; history of bleeding or haemostatic disorders. Pregnancy.

Other Drug Interactions

Co-admin with NSAIDs may increase the risk of stomach and intestinal bleeding. High-dose clopidogrel may lead to increased warfarin levels thus increasing the risk of bleeding. High-dose clopidogrel may also inhibit P450 (2C9), thus interfering with the metabolism of phenytoin, tamoxifen, torasemide, fluvastatin and some NSAIDs.

Other Interactions

Information Not Available

Dosage

Oral
Prophylaxis of thromboembolic disorders
Adult: 75 mg once daily.
CrCl (ml/min)  Dosage Recommendation
5-15           Use with caution.

Hepatic impairment: Severe
hepatic impairment: Use with caution.

Oral
Acute coronary syndrome
Adult: For ST-elevation myocardial infarction: In combination with aspirin: 75 mg once daily. Patients ≤75 years old may be given a loading dose of 300 mg. Continue treatment for up to 28 days. For unstable angina, non-ST-elevation myocardial infarction: Initial: 300 mg loading dose, followed by 75 mg once daily (with aspirin 75-325 mg once daily).

Food(before/after)

May be taken with or without food.

List of Contraindications

Clopidogrel and Pregnancy

Caution when used during pregnancy.


Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Clopidogrel and Lactation

Contraindicated in lactation

Clopidogrel and Children

Safety and efficacy not established

Clopidogrel and Geriatic

Information Not Available

Clopidogrel and Other Contraindications

Hypersensitivity. Active pathological bleeding. admin within 7 days after MI and ischaemic stroke, coagulation disorders. Lactation.

Storage

Oral
Store at 25°C.

Lab interference

Oral
Store at 25°C.

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