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Clopidogrel

Classification

Antiplatelet agent, P2Y12 antagonist

Indications

ACP as part of CHAMP pathway: Adjunctive therapy to support thrombolysis in ST elevation myocardial infarction

Contraindications

Hypersensitivity (e.g., anaphylaxis) to clopidogrel or any components of the formulation
Active pathological bleeding
Significant liver impairment or jaundice

Adult dosages

ACP as part of CHAMP pathway

For patients less than 75 years of age
- 300 mg PO
For patients over 75 years of age
- 75 mg PO

Pediatric Considerations And Dosing

Not authorized in pediatrics

Mechanism Of Action

Irreversibly blocks the P2Y12 component on platelet surfaces, preventing activation of the glycoprotein IIb/IIIa complex, reducing platelet aggregation.

Pharmacokinetics

Following oral administration:

Onset: within 2 hours
Peak effect: within 6 hours
Duration: lifespan of platelet
Metabolism: hepatic

Adverse Effects

Bleeding is associated with the use of clopidogrel and can occur at virtually any site. The risk of bleeding is multifactorial and includes concurrent use of multiple agents that affect clotting. Monitor carefully.

Overdose

Considered unlikely.

Warning And Precautions

Caution is advised in patients over the age of 75, or those with a propensity to bleed. Bleeding should be suspected if patients become hypotensive, even if there are no obvious external signs of hemorrhage.