Clopidogrel
- Atc Codes:B01AC04
- CAS Codes:120202-66-6#113665-84-2
- PHARMGKB ID:120202-66-6#113665-84-2
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Clogagren, Clogombix, Clogrelhexal, Clopidogrel, Grelidohex, Grepid, Iscover, Plavix, Zopya, Zylagren, Zyllt; Belgium: Clopidogrel, Plavix; Bulgaria: Clopidogrel, Iscover, Plavix, Zyllt; Cyprus: Plavix; Czech Republic: Agrelex, Carder, Clopidogrel, Clopithan, Cloroden, Defrozyp, Egitromb, Grepid, Hemafluid, Iscover, Lofradyk, Nofardom, Perclod, Picturlop, Plavix, Plavocorin, Trogran, Trombex, Vatoud, Zopya, Zylagren, Zyllt; Denmark: Clopidogrel, Grepid, Plavix; Estonia: Clopidogrel, Clopigamma, Clopimef, Clopirod, Grepid, Iscover, Lofradyk, Miflexin, Nofardom, Plavix, Plavocorin, Trombex, Zopya, Zyllt; Finland: Plavix; France: Clopidogrel, Plavix; Germany: Carder, Clogombix, Clogrelhexal, Clopex, Clopianne, Clopicaro, Clopidobeta, Clopidocard, Clopidocor, Clopidogrel, Clopifloc, Clopigamma, Clopihex, Clopilux, Clopinovo, Cloriocard, Clotromboz, Grepid, Hemafluid, Iscover, Plavix, Plavocorin, Pontius, Revlis, Rokulan, Subarcan, Thrombogrel; Greece: Clodel, Clopidogrel, Clovelen, Dapixol, Darxa, Globel, Greligen, Grepid, Iscover, Niaclop, Platel, Plavidosa, Plavix, Plavogrel, Sanvix, Throimper; Hungary: Agrelex, Atrombin, Clopidogrel, Egitromb, Iscover, Kafidogrel, Kardogrel, Kerberan, Lofradyk, Nofardom, Plagrel, Plavix, Trombex; Ireland: Clodel, Clopidgrel, Clopidogrel, Grepid, Iscover, Plavix; Italy: Plavix; Latvia: Clopidogrel, Clopimef, Egitromb, Grepid, Iscover, Plavix, Plavocorin, Trombex, Zopya, Zylagren, Zyllt; Lithuania: Clopidogrel, Clopimef, Clopirod, Egitromb, Grepid, Iscover, Nofardom, Plavix, Trombex, Zopya, Zylagren, Zyllt; Luxembourg: Iscover, Plavix; Malta: Iscover, Plavix; Netherlands: Clopidogrel, Iscover, Plavix, Zopya, Zylagren, Zyllt; Poland: Areplex, Clopidix, Clopidogrel, Egitromb, Iscover, Klopidogrel, Plavix, Trombex, Zyllt; Portugal: Clopidogrel, Grepid, Iscover, Pegorel, Perclod, Picturlop, Plavix, Pravidel, Rokulan, Sarix, Subarcan, Vatoud, Zopya, Zylagren, Zyllt; Romania: Clopdogrel, Clopidogrel, Clopigamma, Clopithan, Cloroden, Egitromb, Grepid, Iscover, Lofradyk, Nofardom, Picturlop, Plavix, Plavocorin, Trombex, Tuxedon, Vatoud, Zopya, Zylagren, Zyllt; Slovakia: Agrelex, Carder, Clopidogrel, Clopigamma, Clopithan, Grepid, Iscover, Klopidogrel, Nofardom, Picturlop, Platarex, Plavix, Plavocorin, Tessyron, Trombex, Zopya, Zylagren, Zyllt; Slovenia: Agrelex, Iscover, Plavix; Spain: Clopidogrel, Iscover, Plavix; Sweden: Clopidep, Clopidim, Clopidogrel, Clopidorin, Clopirod, Clopispes, Clopithan, Clotromboz, Grepid, Iscover, Klopidogrel, Plavix, Zopya, Zylagren, Zyllt; UK: Clopidogrel, Plavix.
North America
Canada: Plavix; USA: Plavix.
Latin America
Argentina: Antiplaq, Ariclopin, Clodian, Clopidogrel, Iscover, Klopik, Nabratin, Nefazan, Plavix, Pleyar, Troken; Brazil: Iscover, Plavix; Mexico: Iscover, Plavix.
Asia
Japan: Plavix.
Drug combinations
Clopidogrel and Aspirin
Chemistry
Clopidogrel Bisulfate: C~16~H~16~ClNO~2~S H~2~SO~4~. Mw: 419.90. (1) Thieno[3,2-c]pyridine-5(4H)-acetic acid, α-(2-chlorophenyl)-6,7-dihydro-, methyl ester, (S)-, sulfate (1:1); (2) Methyl (+)-(S)-α-(o-chlorophenyl)-6,7-dihydrothieno[3,2-c]pyridine-5(4H)-acetate, sulfate (1:1). CAS-120202-66-6; CAS-113665-84-2 (clopidogrel)(1997).
Pharmacologic Category
Antithrombotic Agents; Platelet-aggregation Inhibitors. (ATC-Code: B01AC04).
Mechanism of action
Platelet-aggregation inhibitory activity is dependent on hepatic transformation of clopidogrel to an active metabolite. This active metabolite irreversibly modifies the P2Y12 platelet receptor, inhibiting the binding of ADP. This prevents the ADP activation of the GPII~b~/III~a~ receptor complex, thereby reducing platelet aggregation. Also inhibits ADP-mediated release of platelet dense granule (e.g. ADP, calcium, serotonin) and α-granule (e.g. fibrinogen, thrombospondin) contents that augment platelet aggregation.
Therapeutic use
Reduces rate of atherothrombotic events (myocardial infarction, stroke, vascular deaths) in recent myocardial infarction or stroke, or established peripheral arterial disease. Reduces rate of atherothrombotic events in unstable angina or non-ST-segment elevation acute coronary syndromes.
Pregnancy and lactiation implications
Teratogenic effects not observed in animals. Use during pregnancy only if clearly needed. Not recommended during lactation.
Unlabeled use
In aspirin-allergic patients, initial treatment of acute coronary syndromes or prevention of coronary artery bypass graft closure.
Contraindications
Hypersensitivity to clopidogrel or any component of the formulation. Active pathological bleeding such as peptic ulcer disease or intracranial hemorrhage. Coagulation disorders.
Warnings and precautions
Cases of thrombotic thrombocytopenic purpura, resulting in some fatalities, reported. Caution in platelet disorders, bleeding disorders and/or at increased risk for bleeding. Caution in severe hepatic impairment. Use with caution in patients receiving either anticoagulants (e.g. heparin, warfarin) or other platelet aggregation inhibitors (increased bleeding risk). Use with caution in severe renal impairment. In patients who have received bare-metal or drug-eluting stents (sirolimus or paclitaxel), interruption of antiplatelet therapy may result in stent thrombosis with subsequent fatal and nonfatal myocardial infarction.