Clopidogrel
Clopidogrel is an antiplatelet agent used in the management of cardiovascular disease. It was previously used when aspirin was not tolerated or contraindicated but there are now a number of conditions for which clopidogrel is used in addition to aspirin, for example in patients with an acute coronary syndrome. Following the 2010 NICE technology appraisal clopidogrel is also now first-line in patients following an ischaemic stroke and in patients with peripheral arterial disease.
Clopidogrel belongs to a class of drugs known as thienopyridines which have a similar mechanism of action. Other examples include:
Mechanism
Interactions
Clopidogrel belongs to a class of drugs known as thienopyridines which have a similar mechanism of action. Other examples include:
- prasugrel
- ticagrelor
- ticlopidine
Mechanism
- antagonist of the P2Y12 adenosine diphosphate (ADP) receptor, inhibiting the activation of platelets
Interactions
- concurrent use of proton pump inhibitors (PPIs) may make clopidogrel less effective (MHRA July 2009)
- this advice was updated by the MHRA in April 2010, evidence seems inconsistent but omeprazole and esomeprazole still cause for concern. Other PPIs such as lansoprazole should be OK - please see the link for more details