Clopidogrel

Introduction

Clopidogrel, also known as Plavix, is a medication used to prevent heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy). It is an oral, thienopyridine-class antiplatelet agent that inhibits blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease.

Pharmacology

Clopidogrel is a prodrug, which means it is metabolized by the body into its active form. This active metabolite inhibits platelet aggregation by irreversibly binding to the P2Y12 subtype of adenosine diphosphate (ADP) receptor on the platelet surface. This prevents ADP from activating platelets, thereby reducing the likelihood of clot formation.

Clinical Uses

Clopidogrel is primarily used for the prevention of events associated with atherosclerotic disease in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease. It is also used in combination with aspirin for patients with acute coronary syndrome or those undergoing percutaneous coronary intervention (PCI).

Side Effects

Like all medications, clopidogrel can have side effects. These can include bleeding, severe neutropenia, and thrombotic thrombocytopenic purpura (TTP). Patients should be monitored for signs of these conditions.

Contraindications

Clopidogrel should not be used in patients with active pathological bleeding such as peptic ulcer or intracranial hemorrhage. It is also contraindicated in patients with hypersensitivity to clopidogrel or any component of the product.

Drug Interactions

Clopidogrel can interact with several other medications, including proton pump inhibitors, other antiplatelet drugs, and anticoagulants. These interactions can increase the risk of bleeding or decrease the effectiveness of clopidogrel.