Clopidogrel is a prodrug. It inhibits platelet activation and aggregation by irreversibly binding its active metabolites to P2Y12 ADP receptors on platelets. A dose-dependent inhibition of platelet aggregation can be observed 2 hours after a single oral administration. A repeated daily dose of 75 mg inhibited ADP-induced platelet aggregation on the first day, and the inhibition reached a steady state between the 3rd and the 7th day.
Acute coronary syndrome: For patients who need to
exert antiplatelet effects within a few hours, start clopidogrel with a single
oral loading dose of 300 mg (4 tablets) and then continue to take 75 mg once
daily. Starting without a loading dose will delay the onset of antiplatelet
effects for several days.
Recent MI, recent stroke, or established peripheral
artery disease: 75 mg orally once daily with no loading dose.
Oral with or without food.
NSAIDs, warfarin, selective serotonin and
norepinephrine reuptake inhibitors (SSRIs, SNRIs): increase the risk of
CYP2C19 inhibitors (omeprazole or esomeprazole):
avoid simultaneous use of Ogilvy Prazole or Esomeprazole
Repaglinide (using Repcomit2C substrate) increases the plasma concentration of Repaglinide
Clopidogrel is contraindicated in the following situations: Allergic to any component of the drug or product. Active pathological bleeding, such as peptic ulcer or intracranial hemorrhage.
Clopidogrel is usually a well-tolerated drug.
Common side effects: bleeding, diarrhea,
gastrointestinal discomfort, bleeding, skin reactions.
Rare side effects: Acquired hemophilia, anemia, angioedema, joint pain, arthritis, bone marrow disease.
There is no adequate and well-controlled study of pregnant women. It should be used during pregnancy only when clearly necessary. It is not known whether clopidogrel is excreted in human milk. The importance of the drug to the mother should be considered and a decision made to stop breastfeeding or discontinue the drug.
Since it is a prodrug, the metabolism of its active metabolites is affected by CYP2C19 (weak metabolizer) gene mutations and drugs that inhibit CYP2C19 (such as omeprazole and esomeprazole).
Simultaneous use of these drugs and CYP2C19 weak
metabolizers may reduce the antiplatelet activity of clopidogrel.
Because it inhibits platelet aggregation during the
entire life cycle (710 days) of platelets, it may increase the risk of
bleeding. In order to restore hemostasis, platelet transfusion within 4 hours
after the loading dose or within 2 hours after the maintenance dose may be less
Discontinuation of clopidogrel increases the risk of cardiovascular events.
Discontinue medication 5 days prior to elective surgery due to risk of severe bleeding.
Clopidogrel was restored immediately after
Thrombotic thrombocytopenic purpura (TTP) is
reported to require urgent treatment, including plasma exchange (plasma
In patients receiving clopidogrel or patients with a history of allergies to other thienopyridines, allergies, including rash, angioedema, or haematological reactions have been reported.
Keep below 30°C temperature in a dry place. Protected from light. Do not freeze. Keep out of the reach of children.