Clopidogrel may show a delayed onset of platelet inhibition of 48 h because it requires activation by two-stage hepatic metabolism.
About : Always Clopidogrel check the BNF link here
- Thienopyridine platelet antagonist P2Y12 receptor blocker
- Ask cardiologist before stopping dual antiplatelet early post stenting.
- Blocks platelet activation
- Works synergistically with Aspirin
- Genetic variations in metabolism
Mode of action
- Prodrug which requires activation in the liver
- Clopidogrel blocks the activation of the platelet P2Y12 receptor - antiplatelet agent
- Selective and irreversible inhibition of ADP binding to platelet receptors
- Prolongs the bleeding time
- NSTEMI (CURE study) treat for up to 1 year
- STEMI (CLARITY study and COMMIT study) for 14 days
- PCI patients (CLASSICS trial and PCI CURE)
- Bare metal stent - at least one month Treatment
- Drug eluting stent - 12 months Aspirin + Clopidogrel treatment
- Aspirin intolerant patients requiring antiplatelet therapy
- Bleeding 1% increased risk of major bleeds
- Trauma, imminent surgery, Thrombocytopenia
- Effects reduced by omeprazole
- STEMI/ACS: Loading dose 300-600 mg po
- ACS/Ischaemic Stroke/TIA:Maintenance dose 75 mg od
- Diarrhoea, Rash, Dyspepsia, Bleeding takes 7 days for effect to reduce.