Clopidogrel
Indications
Prevention of vascular ischemic events in patients with symptomatic atherosclerosis
Acute coronary syndrome without ST-segment elevation (NSTEMI)
ST elevation MI (STEMI)
prevention of thrombosis after placement of intracoronary stent
Administration/Absorption
oral
Absorption is at least 50%
Distribution
Mechanism
activated in the liver by cytochrome P450 enzymes, including CYP2C19
acts by forming a disulfide bridge with the platelet ADP receptor
Excretion
elimination half-life of about eight hours
Side effects
Severe neutropenia (low white blood cells) (Incidence: 1/2,000)
Thrombotic thrombocytopenic purpura (TTP) (Incidence: 4/1,000,000 patients treated)[15][16]
Hemorrhage - The annual incidence of hemorrhage may be increased by the co-administration of aspirin.[17]
Gastrointestinal Hemorrhage (Incidence: 2.0% annually)
Cerebral Hemorrhage (Incidence: 0.1 to 0.4% annually)
Use of non-steroidal anti-inflammatory drugs is discouraged in those taking clopidogrel due to increased risk of digestive tract hemorrhage
Interactions
Contraindications