about Clopidogrel class, uses, side effects contraindications
Clopidogrel
Short Description
Clopidogrel is a drug that prevents blood clots from forming and reduces the risk of myocardial infarction or?stroke?in patients who have had it before.
Clopidogrel is an effective drug in preventing stent-related thromboembolism in people with coronary artery disease.
Category
Chemical class: Thienopyridine derivative
Therapeutic class: Platelet aggregation inhibitor
Pregnancy category: B
Indications
To reduce atherosclerotic events, such as stroke and MI, in patients with atherosclerosis documented by recent stroke, MI, or peripheral artery disease
Adults. 75 mg daily. To reduce atherosclerotic events, such as stroke and MI, in patients with acute coronary syndrome (unstable angina or non–Q-wave MI)
Adults.Loading dose: 300 mg. Maintenance: 75 mg daily. To reduce rate of death, reinfarction, or stroke in patients with ST-segment elevation acute MI
Adults.75 mg once daily. Or, loading dose of 300 mg followed by 75 mg once daily.
Mechanism of Action
Binds to adenosine diphosphate (ADP) receptors on the surface of activated platelets. This action blocks ADP, which deactivates nearby glycoprotein IIb/IIIa receptors and prevents fibrinogen from attaching to receptors. Without fibrinogen, platelets can’t aggregate and form thrombi. Route Onset Peak Duration P.O. 2 hr 3–7 days* 5 days
Contraindications
Active pathological bleeding, including peptic ulcer and intracranial hemorrhage; hypersensitivity to clopidogrel or its components
Interactions
aspirin: Increased risk of bleeding CYP2C19 inhibitors, such as cimetidine, esomeprazole, etravirine, felbamate, fluconazole, fluoxetine, fluvoxamine, ketoconazole, omeprazole, ticlopidine, voriconazole: Decreased plasma clopidogrel level, decreased platelet inhibition fluvastatin, phenytoin, tamoxifen, tolbutamide, torsemide: Interference with metabolism of these
NSAIDs: Increased risk of GI bleeding, interference with NSAID metabolism
warfarin: Prolonged bleeding time, interference with warfarin metabolism
Side Efect
CNS: Confusion, depression, dizziness, fatigue, hallucinations, headache
CV: Chest pain, edema, hypercholesterolemia, hypertension, hypotension, vasculitis
EENT: Altered taste; conjunctival, ocular, or retinal bleeding; epistaxis; rhinitis; taste disorders
GI: Abdominal pain; acute liver failure; colitis; diarrhea; duodenal, gastric, or peptic ulcer; elevated liver function test results; gastritis; indigestion; nausea; noninfectious hepatitis; pancreatitis
GU: Elevated serum creatinine level, glomerulopathy, UTI
HEME: Agranulocytosis, aplastic anemia, neutropenia, pancytopenia, prolonged bleeding time, thrombocytopenic purpura, thrombotic thrombocytopenic purpura, unusual bleeding or bruising
MS: Arthralgia, back pain, myalgia
RESP: Bronchitis, bronchospasm, cough, dyspnea, interstitial pneumonitis, upper respiratory tract infection clopidogrel bisulfate 257 C * With repeated doses.
SKIN: Erythema multiforme, lichen planus, pruritus, purpura, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis
Other: Anaphylaxis, angioedema, flulike symptoms, serum sickness
Cautions
Avoid clopidogrel in patients who have a genetic variation in CYP2C19 or are receiving CYP2C19 inhibitors. Platelet inhibition may decline, increasing the risk of adverse cardiovascular effects after MI. Use clopidogrel cautiously in patients with severe hepatic or renal disease, risk of bleeding from trauma or surgery, or conditions that predispose to bleeding (such as peptic ulcer disease or thrombotic thrombocytopenic purpura). In patient with acute coronary syndrome, expect to give aspirin with clopidogrel.
WARNING Clopidogrel prolongs bleeding time; expect to stop it 5 days before elective surgery. Obtain blood cell count, as ordered, whenever signs and symptoms suggest a hematologic problem. Monitor patient who takes aspirin closely because risk of bleeding is increased. PATIENT SAFTY
Discourage use of NSAIDs, including OTC preparations, during clopidogrel therapy because of potential for bleeding. Caution patient that bleeding may continue longer than usual. Instruct him to report unusual bleeding or bruising. Because he has an increased risk of bleeding, urge patient to inform all other health care providers, including dentists, that he takes clopidogrel before having surgery or other procedures or taking a new drug. Instruct patient to inform his health care providers about his clopidogrel therapy.
trad drugs based on Clopidogrel
| Gen name | Trade name | Catagory name |
| clopidogrel | Plavix | Platelet aggregation inhibitors |
| Clopidogrel | CLOPEX 75 MG FC TABLETS | |
| Clopidogrel | PEDOVEX 75MG FC TABLETS | |
| Clopidogrel | PLAVIX 75 MG TABLET | |
other drugs from same cataogory
| Gen name | trade name | catogry |
| ticagrelor | Brilinta | Platelet aggregation inhibitors |
| clopidogrel | Plavix | Platelet aggregation inhibitors |
| prasugrel | Effient | Platelet aggregation inhibitors |
| aspirin / dipyridamole | Aggrenox | Platelet aggregation inhibitors |
| cilostazol | Pletal | Platelet aggregation inhibitors |
| aspirin | Bayer Aspirin | Platelet aggregation inhibitors |
| aspirin | Bayer Aspirin Extra Strength Plus | Platelet aggregation inhibitors |
| aspirin | Arthritis Pain | Platelet aggregation inhibitors |
| aspirin | Vazalore | Platelet aggregation inhibitors |
| aspirin | St. Joseph Aspirin | Platelet aggregation inhibitors |
| aspirin | Bayer Children's Aspirin | Platelet aggregation inhibitors |
| aspirin / omeprazole | Yosprala | Platelet aggregation inhibitors |
| ticlopidine | Ticlid | Platelet aggregation inhibitors |
| aspirin/pravastatin | Pravigard Pac | Platelet aggregation inhibitors |
| dipyridamole | Persantine | Platelet aggregation inhibitors |
| aspirin | Norwich Aspirin | Platelet aggregation inhibitors |
| aspirin | Miniprin | Platelet aggregation inhibitors |
| cangrelor | Kengreal | Platelet aggregation inhibitors |
| aspirin | Halfprin | Platelet aggregation inhibitors |
| aspirin | Genacote | Platelet aggregation inhibitors |
| aspirin | Entercote | Platelet aggregation inhibitors |
| aspirin | Ecpirin | Platelet aggregation inhibitors |
| aspirin | Ecotrin | Platelet aggregation inhibitors |
| aspirin | Easprin | Platelet aggregation inhibitors |
| aspirin | Durlaza | Platelet aggregation inhibitors |
| caplacizumab | Cablivi | Platelet aggregation inhibitors |
| aspirin | Bayer Aspirin Regimen | Platelet aggregation inhibitors |
| aspirin | Aspirtab | Platelet aggregation inhibitors |
| aspirin | Aspiritab | Platelet aggregation inhibitors |
| aspirin | Aspir-Low | Platelet aggregation inhibitors |
| aspirin | Aspi-Cor | Platelet aggregation inhibitors |
| aspirin | Aspergum | Platelet aggregation inhibitors |
| aspirin | Ascriptin | Platelet aggregation inhibitors |