Clopidogrel

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Therapeutic Indication

Prevention of heart attack (myocardial infarction)
Prevention of stroke
Acute coronary syndrome (ACS)
Peripheral arterial disease (PAD)
Post-angioplasty and stent placement
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Clopidogrel

Tablet

Clopidogrel is used to prevent heart attacks and strokes in persons with heart disease a recent heart attack. Clopidogrel is a drug of a platelet inhibitor which is used to reduce the risk of myocardial infarction and stroke.Clopidogrel which is indicated to reduce the risk of myocardial infarction for patients with non-ST elevated acute coronary syndrome ACS, patients with ST-elevated myocardial infarction, and in recent MI, strok or with peripheral arterial disease. It is used to prevent blood clots if you have chest pain ,poor circulation in your legs.
The medication comes in the form of a tablet which is taken by mouth Clopidogrel oral tablet is also available as the brand-name Plavix. It’s also available as a generic drug. Clopidogrel can be used as part of a combination therapy, which means you may need to take it with other drugs. This is decided by the doctor only.
Clopidogrel is also used with aspirin to treat worsening chest pain , unstable angina and to keep blood vessels open and prevent blood clots after certain procedures such as cardiac stent and provides additional benefit to patients with acute coronary syndromes already taking aspirin.
Clopidogrel is mainly used to prevent heart attack and stroke in people who are at high risk of these events, including those with a history of myocardial infarction and other forms of acute coronary syndrome, stroke, and those with peripheral artery disease. Clopidogrel's is also beneficial in those who smoke cigarettes with only slight (8%) benefit in those who do not smoke cigarettes.

Speciality Antiplatelet Agent
Tags Cardiac Care | Blood Thinner
Strength
  • 75 mg
Packing Size
  • 10 Tablets

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Mechanism

Clopidogrel is known as a prodrug, which is activated in two steps: by CYP2C19, CYP1A2 and CYP2B6, then by CYP2C19, CYP2C9, CYP2B6 and CYP3A. The active metabolite then specifically and irreversibly inhibits the P2Y12 subtype of ADP receptor, which is the main key factor in activation of platelets and eventual cross-linking by the protein fibrin. Platelet inhibition can be demonstrated two hours after a single dose of oral clopidogrel, somehow the onset of action is slow, so a loading dose of either 600 or 300 mg is administered when a rapid effect is needed.
Clopidogrel is metabolized to its active form by carboxylesterase-1. This binding prevents ADP binding to P2Y12 receptors, activation of the glycoprotein GPIIb/IIIa complex, and platelet aggregation.

Pharmacokinetics

  • Absorption: Rapidly absorbed after oral administration with good bioavailability.
  • Distribution: Extensively bound to plasma proteins.
  • Metabolism: Prodrug activated in liver via CYP2C19 enzyme.
  • Elimination: Excreted through urine and feces as metabolites.

Side Effects

  • Bleeding or bruising
  • Gastrointestinal discomfort
  • Diarrhea
  • Rash
  • Rarely severe bleeding

Contraindication

  • Active bleeding (e.g., peptic ulcer, intracranial hemorrhage)
  • Hypersensitivity to Clopidogrel
  • Severe liver impairment

Interaction

  • Increased bleeding risk with anticoagulants
  • Reduced effect with proton pump inhibitors (like omeprazole)
  • Caution with NSAIDs
  • Interaction with CYP2C19 inhibitors

Warning and Precautions

  • Monitor for signs of bleeding
  • Use cautiously before surgery
  • Avoid abrupt discontinuation
  • Use under medical supervision