Clopidogrel Dosage

How do you administer this medicine?
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Dosage of Clopidogrel in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet,

Oral:

Plavix: 75 mg, 300 mg [DSC]

Generic: 75 mg, 300 mg

Dosing: Adult

Acute coronary syndrome:

Note: Routine platelet-function testing or genetic testing for CYP2C19 polymorphisms is not recommended (ACC/AHA [Levine 2016]; Scott 2013; Sibbing 2019).

ST-segment elevation myocardial infarction: Note: Regardless of the reperfusion strategy, administer Clopidogrel in combination with a parenteral anticoagulant and aspirin (ACCF/AHA [O'Gara 2013]).

If using fibrinolytic therapy for reperfusion:

Age ≤75 years:

Oral: Initial loading dose: 300 mg once at the time of diagnosis; followed by 75 mg once daily (ACCF/AHA [O'Gara 2013]; Sabatine 2005a).

Age >75 years:

Oral: 75 mg once daily (ACCF/AHA [O'Gara 2013]).

Patient requires percutaneous coronary intervention following fibrinolytic therapy:

Fibrinolytic administered with a loading dose of Clopidogrel:

Oral: Continue 75 mg once daily (do not administer an additional loading dose) (ACCF/AHA [O'Gara 2013]).

Fibrinolytic administered ≤24 hours ago without a loading dose of Clopidogrel:

Oral: Initial: 300 mg once prior to percutaneous coronary intervention (PCI); followed by 75 mg once daily after PCI (ACCF/AHA [O'Gara 2013]).

Fibrinolytic administered >24 hours ago without a loading dose of Clopidogrel:

Oral: Initial: 600 mg once prior to PCI; followed by 75 mg once daily after PCI (ACCF/AHA [O'Gara 2013]).

If using percutaneous coronary intervention for reperfusion (alternative agent) (off-label use): Note: Some experts prefer ticagrelor or prasugrel over Clopidogrel unless there is high risk for bleeding (Lincoff 2019; Wallentin 2009; Wiviott 2007).

Oral: Initial: 600 mg once as early as possible before PCI; followed by 75 mg once daily after PCI (ACCF/AHA [O'Gara 2013]; Dangas 2009; Mehta 2010).

If no planned reperfusion strategy (alternative agent): Note: Some experts prefer ticagrelor over Clopidogrel (Lincoff 2019).

Oral: Initial: 300 mg once at the time of diagnosis; followed by 75 mg once daily (Lincoff 2019).

Duration of therapy: Clopidogrel plus aspirin (dual antiplatelet therapy [DAPT]) should be continued for ≥12 months unless bleeding is a concern. If there have been no major bleeding complications after 12 months, continuation of DAPT may be considered. Reevaluate the need for DAPT at regular intervals based on bleeding and thrombotic risks. When DAPT is complete, discontinue Clopidogrel and continue aspirin indefinitely (ACC/AHA [Levine 2016]; ACCF/AHA [O'Gara 2013]; Lincoff 2019; Mauri 2014).

Non-ST-segment elevation acute coronary syndromes: Note: Regardless of the management strategy, administer Clopidogrel in combination with a parenteral anticoagulant and aspirin (ACC/AHA [Amsterdam 2014]).

If using an ischemia-guided approach (medical management) (alternative agent): Note: Some experts prefer ticagrelor over Clopidogrel (Cutlip 2019a).

Oral: Initial: 300 or 600 mg once at the time of diagnosis; followed by 75 mg once daily (ACC/AHA [Amsterdam 2014]). Some experts prefer an initial dose of 600 mg unless there is high risk for bleeding, in which case, an initial dose of 300 mg is also appropriate (Cutlip 2019a).

If using an invasive approach (reperfusion using percutaneous coronary intervention) (alternative agent): Note: Some experts prefer ticagrelor or prasugrel over Clopidogrel unless there is high risk for bleeding (Cutlip 2019a; Wallentin 2009; Wiviott 2007).

Oral: Initial: 600 mg once as early as possible before PCI; followed by 75 mg once daily after PCI (ACC/AHA [Amsterdam 2014]).

Duration of therapy: Clopidogrel plus aspirin (DAPT) should be continued for ≥12 months unless bleeding is a concern. If there have been no major bleeding complications after 12 months, continuation of DAPT may be considered. Reevaluate the need for DAPT at regular intervals based on bleeding and thrombotic risks. When DAPT is complete, discontinue Clopidogrel and continue aspirin indefinitely (ACC/AHA [Amsterdam 2014]; ACC/AHA [Levine 2016]; Cutlip 2019a; Mauri 2014; Mehta 2001; Yusuf 2001).

Percutaneous coronary intervention for stable ischemic heart disease (off-label use): Note: Administer Clopidogrel in combination with a parenteral anticoagulant and aspirin for patients who undergo PCI with stenting (ACCF/AHA/SCAI [Levine 2011]).

Oral: Initial: 600 mg once, administered ≥2 hours before PCI, ideally ≥24 hours before PCI; followed by 75 mg once daily (ACCF/AHA/SCAI [Levine 2011]; Cutlip 2020).

Duration of therapy: Upon completion of the recommended duration of DAPT (Clopidogrel plus aspirin), discontinue Clopidogrel and continue aspirin indefinitely (ACC/AHA [Levine 2016]; Cutlip 2019c):

• Bare metal stent implantation: DAPT for a minimum of 1 month (ACC/AHA [Levine 2016]). Some experts recommend at least 6 months and up to 12 months; in patients at high bleeding risk, shorter duration may be considered. After 6 to 12 months, assess bleeding and ischemic risks to determine if patient should receive longer therapy (eg, for an additional 18 to 24 months) (Cutlip 2019c).

• Drug eluting stent implantation: DAPT for at least 6 months and up to 12 months; if bleeding occurs or patient is at high risk of bleeding, may stop after 3 months (ACC/AHA [Levine 2016]). After 6 to 12 months, assess bleeding and ischemic risks to determine if patient should receive longer therapy (eg, for an additional 18 to 24 months) (Cutlip 2019c).

Carotid artery atherosclerosis, symptomatic (alternative agent) (off-label use): Note: For patients who are intolerant of aspirin.

Oral: 75 mg once daily (ACCP [Alonso-Coello 2012]; Cucchiara 2019).

Carotid artery stenting (off-label use):

Initial:

Initiation ≥48 hours before procedure:

Oral: 75 mg

twice daily in combination with aspirin (Brott 2010; Fairman 2019).

Initiation <48 hours of procedure:

Oral: 450 mg once ≥4 hours before procedure in combination with aspirin (Brott 2010; Fairman 2019).

Maintenance:

Oral: 75 mg

once daily in combination with aspirin for ≥6 weeks; after 6 weeks of DAPT with Clopidogrel and aspirin, assess bleeding and ischemic risks to determine total duration of therapy; upon completion of DAPT, discontinue Clopidogrel and continue aspirin indefinitely. In patients with history of neck irradiation, some experts recommend continuing Clopidogrel plus aspirin indefinitely (Brott 2010; Fairman 2019).

Coronary artery bypass graft surgery (off-label use):

Aspirin-allergic or aspirin-intolerant patients:

Oral: 75 mg once daily; continue indefinitely (AHA [Kulik 2015]).

Following off-pump coronary artery bypass graft surgery:

Oral: 75 mg once daily in combination with aspirin for 1 year, then discontinue Clopidogrel and continue aspirin indefinitely (AHA [Kulik 2015]; Deo 2013; Mannacio 2012).

Patients with acute coronary syndrome followed by coronary artery bypass graft surgery:

Oral: 75 mg once daily in combination with aspirin for 1 year, then discontinue Clopidogrel and continue aspirin indefinitely (AHA [Kulik 2015]). Some experts do not use Clopidogrel postoperatively in these patients (Aranki 2020).

Peripheral atherosclerotic disease (upper or lower extremity; with or without revascularization):

Oral: 75 mg once daily (ACCP [Alonso-Coello 2012]; AHA/ACC [Gerhard-Herman 2017]; CAPRIE 1996).

Stable ischemic heart disease (alternative agent) (off-label use): Note: Aspirin is preferred; Clopidogrel is an alternative for patients who have a history of GI bleeding or are allergic to aspirin (ACCF/AHA [Fihn 2012]).

Oral: 75 mg once daily (ACCF/AHA [Fihn 2012]; ACCP [Vandvik 2012]; CAPRIE 1996).

Stroke/Transient ischemic attack:

Intracranial atherosclerosis (50% to 99% stenosis of a major intracranial artery), secondary prevention: Note: Aspirin is recommended for all patients; may consider Clopidogrel (in combination with aspirin) for short-term use in patients with recent stroke or transient ischemic attack (within 30 days) (AHA/ASA [Kernan 2014]; Ehtisham 2019). For long-term stroke prevention, indefinite use of Clopidogrel monotherapy is an alternative to aspirin (AHA/ASA [Kernan 2014]).

Oral: 75 mg once daily in combination with aspirin; duration of Clopidogrel depends on degree of stenosis.

Stenosis of 50% to 69%: Clopidogrel may be added to aspirin for 21 days; after 21 days, discontinue Clopidogrel and continue aspirin indefinitely (Ehtisham 2019).

Stenosis of 70% to 99%: Clopidogrel may be added to aspirin for 90 days; after 90 days, discontinue Clopidogrel and continue aspirin indefinitely (AHA/ASA [Kernan 2014]; Derdeyn 2014; Ehtisham 2019).

Ischemic stroke or transient ischemic attack, noncardioembolic, secondary prevention:

Oral: 75 mg once daily.

Minor ischemic stroke (NIHSS score ≤3) or high-risk transient ischemic attack (ABCD score ≥4): Note: Short-term use of Clopidogrel in combination with aspirin may be considered for initiation as soon as possible and within 24 hours of stroke onset. If an IV thrombolytic was administered, delay starting antiplatelet therapy for ≥24 hours but administer as soon as possible thereafter (AHA/ASA [Kernan 2014]; AHA/ASA [Powers 2018]; Johnston 2018; Wang 2013).

Oral: Initial: 300 to 600 mg in combination with aspirin; followed by 75 mg once daily for 21 days; after 21 days, discontinue Clopidogrel and continue aspirin indefinitely (AHA/ASA [Kernan 2014]; AHA/ASA [Powers 2018]; Johnston 2018; Wang 2013).

Transcatheter aortic valve replacement (thromboprophylaxis) (off-label use):

Oral: 300 mg once prior to valve implantation in combination with aspirin; followed by 75 mg once daily for 3 to 6 months depending on the type of valve implanted; after completion of Clopidogrel, continue aspirin indefinitely (ACC [Otto 2017]; AHA/ACC [Nishimura 2014], AHA/ACC [Nishimura 2017]; Kalich 2018). To minimize risk of bleeding complications, may give aspirin or Clopidogrel alone and reserve dual antiplatelet therapy during the first 3 to 6 months for patients at high risk of a thrombotic event; for either strategy, continue aspirin indefinitely (Kuno 2019).

Transitioning between P2Y inhibitor to Clopidogrel:

Transitioning from prasugrel:

Patient received prasugrel for ≤5 days: Give a Clopidogrel 300 mg loading dose 24 hours after the last dose of prasugrel, followed by 75 mg once daily; some experts do not administer a loading dose (Lincoff 2019).

Patient received prasugrel for >5 days: Give Clopidogrel 75 mg once daily, starting 24 hours after the last dose of prasugrel (Kerneis 2013; Lincoff 2019).

Transitioning from ticagrelor: Give a Clopidogrel 600 mg loading dose 12 hours after the last dose of ticagrelor, followed by 75 mg once daily (Franchi 2018).

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Antiplatelet effect: Limited data available:

Infants and Children ≤24 months: In the PICOLO trial, a dose of 0.2 mg/kg/dose once daily was found to achieve a mean inhibition of platelet aggregation similar to adults receiving the recommended dose; Note: This study included pediatric patients with a systemic-to-pulmonary artery shunt, intracardiac or intravascular stent, Kawasaki disease, or arterial graft; 79% of patients received concomitant aspirin (Li 2008).

Children >2 years and Adolescents: Initial dose: 1 mg/kg once daily; titrate to response; in general, do not exceed adult dose (Finkelstein 2005; Soman 2006).

CYP2C19 poor metabolizers (ie, CYP2C19*2 or *3 carriers): Specific pediatric recommendations are lacking; based on experience in adult patients, routine genetic testing is not recommended in patients treated with Clopidogrel undergoing PCI, testing may be considered to identify poor metabolizers who would be at risk for poor outcomes while receiving Clopidogrel; if identified, these patients may be considered for an alternative P2Y12 inhibitor (Levine 2011).

What other drugs will affect Clopidogrel?

Certain other medicines may increase your risk of bleeding. Tell your doctor if you take aspirin, especially if you have had a stroke. Talk to your doctor about whether you should take aspirin with Clopidogrel.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Clopidogrel, especially:

This list is not complete. Other drugs may interact with Clopidogrel, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Clopidogrel interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Clopidogrel, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Acalabrutinib: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.): May enhance the antiplatelet effect of other Agents with Antiplatelet Properties. Monitor therapy

Alpelisib: BCRP/ABCG2 Inhibitors may increase the serum concentration of Alpelisib. Management: Avoid coadministration of BCRP/ABCG2 inhibitors and alpelisib due to the potential for increased alpelisib concentrations and toxicities. If coadministration cannot be avoided, closely monitor for increased alpelisib adverse reactions. Consider therapy modification

Amiodarone: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Monitor therapy

Amodiaquine: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Amodiaquine. Avoid combination

Anticoagulants: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Anticoagulants. Exceptions: Bemiparin; Enoxaparin; Heparin. Monitor therapy

Apixaban: Antiplatelet Agents (P2Y12 Inhibitors) may enhance the adverse/toxic effect of Apixaban. Specifically, the risk for bleeding may be increased. Management: Carefully consider risks and benefits of this combination and monitor closely; Canadian labeling recommends avoiding prasugrel or ticagrelor. Consider therapy modification

Bemiparin: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Bemiparin. Management: Avoid concomitant use of bemiparin with antiplatelet agents. If concomitant use is unavoidable, monitor closely for signs and symptoms of bleeding. Consider therapy modification

BuPROPion: CYP2B6 Inhibitors (Weak) may increase the serum concentration of BuPROPion. Monitor therapy

Calcium Channel Blockers: May diminish the therapeutic effect of Clopidogrel. Exceptions: Clevidipine. Monitor therapy

Cangrelor: May diminish the antiplatelet effect of Clopidogrel. More specifically, while the use of Cangrelor is expected to increase total platelet inhibition in patients who have previously received Clopidogrel, Cangrelor is expected to decrease binding of Clopidogrel metabolites to P2Y12 receptors and thus reduce the extent of irreversible platelet inhibition. Management: Avoid administration of Clopidogrel until cangrelor infusion is discontinued. Consider therapy modification

Cephalothin: Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Cephalothin. Specifically, the risk for bleeding may be increased. Monitor therapy

Cladribine: BCRP/ABCG2 Inhibitors may increase the serum concentration of Cladribine. Management: Avoid concomitant use of BCRP inhibitors during the 4 to 5 day oral cladribine treatment cycles whenever possible. If combined, consider dose reduction of the BCRP inhibitor and separation in the timing of administration. Consider therapy modification

Collagenase (Systemic): Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Collagenase (Systemic). Specifically, the risk of injection site bruising and/or bleeding may be increased. Monitor therapy

CYP2C19 Inducers (Strong): May increase serum concentrations of the active metabolite(s) of Clopidogrel. Monitor therapy

CYP2C19 Inhibitors (Moderate): May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Due to a risk for impaired Clopidogrel effectiveness with such a combination, carefully consider the need for a moderate CYP2C19 inhibitor in patients receiving Clopidogrel. Monitor patients closely for evidence of a diminished response to Clopidogrel. Consider therapy modification

CYP2C19 Inhibitors (Strong): May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Due to a risk for impaired Clopidogrel effectiveness with such a combination, carefully consider the need for a strong CYP2C19 inhibitor in patients receiving Clopidogrel. Monitor patients closely for evidence of a diminished response to Clopidogrel. Consider therapy modification

Dabigatran Etexilate: Antiplatelet Agents (P2Y12 Inhibitors) may enhance the adverse/toxic effect of Dabigatran Etexilate. Specifically, the risk of bleeding may be increased. Antiplatelet Agents (P2Y12 Inhibitors) may increase the serum concentration of Dabigatran Etexilate. Specifically, Clopidogrel may increase dabigatran serum concentrations. Management: Carefully consider risks and benefits of this combination and monitor closely; Canadian labeling recommends avoiding prasugrel or ticagrelor. Consider therapy modification

Dabrafenib: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Dabrafenib. Monitor therapy

Dasabuvir: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Dasabuvir. Monitor therapy

Dasatinib: May enhance the anticoagulant effect of Agents with Antiplatelet Properties. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs. Monitor therapy

Deoxycholic Acid: Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Deoxycholic Acid. Specifically, the risk for bleeding or bruising in the treatment area may be increased. Monitor therapy

Desloratadine: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Desloratadine. Monitor therapy

Edoxaban: Antiplatelet Agents (P2Y12 Inhibitors) may enhance the adverse/toxic effect of Edoxaban. Specifically, the risk of bleeding may be increased. Management: Carefully consider the anticipated risks and benefits of this combination. If combined, increased monitoring for bleeding is recommended. Consider therapy modification

Enoxaparin: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Enoxaparin. Management: Discontinue antiplatelet agents prior to initiating enoxaparin whenever possible. If concomitant administration is unavoidable, monitor closely for signs and symptoms of bleeding. Consider therapy modification

Enzalutamide: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Enzalutamide. Monitor therapy

Erythromycin (Systemic): May diminish the antiplatelet effect of Clopidogrel. Monitor therapy

Esomeprazole: May diminish the antiplatelet effect of Clopidogrel. Esomeprazole may decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Clopidogrel prescribing information recommends avoiding concurrent use with esomeprazole. Rabeprazole or pantoprazole may be lower-risk alternatives to esomeprazole. Consider therapy modification

Etravirine: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Consider alternatives to Clopidogrel in patients treated with etravirine. If combined, monitor for reduced Clopidogrel effectiveness. Consider therapy modification

Fat Emulsion (Fish Oil Based): May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Monitor therapy

FentaNYL: May diminish the antiplatelet effect of Antiplatelet Agents (P2Y12 Inhibitors). FentaNYL may decrease the serum concentration of Antiplatelet Agents (P2Y12 Inhibitors). Monitor therapy

FluvoxaMINE: May enhance the adverse/toxic effect of Clopidogrel. Specifically, the risk for bleeding may be increased. FluvoxaMINE may decrease serum concentrations of the active metabolite(s) of Clopidogrel. Monitor therapy

Glucosamine: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Grapefruit Juice: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Advise patients receiving Clopidogrel to minimize consumption of grapefruit and grapefruit juice. Consumption of three 200 mL glasses of grapefruit juice a day may substantially reduce Clopidogrel antiplatelet effects. Consider therapy modification

Heparin: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Heparin. Management: Decrease the dose of heparin or agents with antiplatelet properties if coadministration is required. Consider therapy modification

Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry): May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Bleeding may occur. Management: Avoid combination when possible. If used, monitor more closely for evidence of bleeding. Discontinue herbal products with anticoagulant or antiplatelet actions 2 weeks prior to surgical, dental, or invasive procedures. Consider therapy modification

Ibritumomab Tiuxetan: Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Ibritumomab Tiuxetan. Both agents may contribute to impaired platelet function and an increased risk of bleeding. Monitor therapy

Ibrutinib: May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Monitor therapy

Inotersen: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Lansoprazole: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Monitor therapy

Limaprost: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Morphine (Systemic): May diminish the antiplatelet effect of Antiplatelet Agents (P2Y12 Inhibitors). Morphine (Systemic) may decrease the serum concentration of Antiplatelet Agents (P2Y12 Inhibitors). Management: Consider alternative anti-ischemic/analgesic therapies (eg, beta-blockers, nitroglycerin) in patients with acute coronary syndromes treated with a P2Y12 inhibitor when possible. The risks associated with other opioids are unknown. Consider therapy modification

Multivitamins/Fluoride (with ADE): May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Multivitamins/Minerals (with ADEK, Folate, Iron): May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Multivitamins/Minerals (with AE, No Iron): May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Obinutuzumab: Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Obinutuzumab. Specifically, the risk of serious bleeding-related events may be increased. Monitor therapy

Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir. Specifically, the concentrations of the dasabuvir component may be increased. Monitor therapy

Omega-3 Fatty Acids: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Omeprazole: May diminish the antiplatelet effect of Clopidogrel. Omeprazole may decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Clopidogrel labeling recommends avoiding concurrent omeprazole due to a possible decrease in Clopidogrel effectiveness. Rabeprazole or pantoprazole may be lower-risk alternatives to omeprazole. Consider therapy modification

Ozanimod: BCRP/ABCG2 Inhibitors may increase serum concentrations of the active metabolite(s) of Ozanimod. Avoid combination

PACLitaxel (Conventional): CYP2C8 Inhibitors (Moderate) may increase the serum concentration of PACLitaxel (Conventional). Monitor therapy

PACLitaxel (Protein Bound): CYP2C8 Inhibitors (Moderate) may increase the serum concentration of PACLitaxel (Protein Bound). Monitor therapy

Pantoprazole: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Due to the possible risk for impaired Clopidogrel effectiveness, clinicians should carefully consider the need for proton pump inhibitor therapy in patients receiving Clopidogrel. Other acid-lowering therapies do not appear to share this interaction. Monitor therapy

PAZOPanib: BCRP/ABCG2 Inhibitors may increase the serum concentration of PAZOPanib. Avoid combination

Pentosan Polysulfate Sodium: May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Specifically, the risk of bleeding may be increased by concurrent use of these agents. Monitor therapy

Pentoxifylline: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Pioglitazone: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Pioglitazone. Monitor therapy

Prostacyclin Analogues: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Repaglinide: Clopidogrel may increase the serum concentration of Repaglinide. Management: Avoid use of Clopidogrel and repaglinide if possible; if the combination must be used, limit total repaglinide daily dose to no more than 4 mg. This is contraindicated in some non-US labeling. Consider therapy modification

Rimegepant: BCRP/ABCG2 Inhibitors may increase the serum concentration of Rimegepant. Avoid combination

Ritonavir: May diminish the antiplatelet effect of Clopidogrel. Ritonavir may decrease serum concentrations of the active metabolite(s) of Clopidogrel. Monitor therapy

Rivaroxaban: Antiplatelet Agents (P2Y12 Inhibitors) may enhance the adverse/toxic effect of Rivaroxaban. Specifically, the risk of bleeding may be increased. Management: Carefully consider risks and benefits of this combination and monitor closely; Canadian labeling recommends avoiding prasugrel or ticagrelor. Consider therapy modification

Rosuvastatin: Clopidogrel may increase the serum concentration of Rosuvastatin. Monitor therapy

Salicylates: Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Salicylates. Increased risk of bleeding may result. Monitor therapy

Selexipag: CYP2C8 Inhibitors (Moderate) may increase serum concentrations of the active metabolite(s) of Selexipag. Management: Reduce the selexipag dose to once daily when combined with moderate CYP2C8 inhibitors. Revert back to twice daily selexipag dosing upon stopping the moderate CYP2C8 inhibitor. Consider therapy modification

Sibutramine: CYP2B6 Inhibitors (Weak) may increase serum concentrations of the active metabolite(s) of Sibutramine. CYP2B6 Inhibitors (Weak) may increase the serum concentration of Sibutramine. Monitor therapy

Sodium Zirconium Cyclosilicate: May decrease serum concentrations of the active metabolite(s) of Clopidogrel. Management: Separate the administration of sodium zirconium cyclosilicate and Clopidogrel by at least 2 hours. Consider therapy modification

Talazoparib: BCRP/ABCG2 Inhibitors may increase the serum concentration of Talazoparib. Monitor therapy

Thrombolytic Agents: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Thrombolytic Agents. Monitor therapy

Tipranavir: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Topotecan: BCRP/ABCG2 Inhibitors may increase the serum concentration of Topotecan. Avoid combination

Treprostinil: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Treprostinil. Monitor therapy

Ubrogepant: BCRP/ABCG2 Inhibitors may increase the serum concentration of Ubrogepant. Management: Use an initial ubrogepant dose of 50 mg and second dose (if needed) of 50 mg when used with a BCRP inhibitor. Consider therapy modification

Urokinase: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Urokinase. Avoid combination

Vitamin E (Systemic): May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy

Warfarin: Clopidogrel may enhance the anticoagulant effect of Warfarin. Monitor therapy

Zanubrutinib: May enhance the antiplatelet effect of Agents with Antiplatelet Properties. Monitor therapy


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References

  1. FDA/SPL Indexing Data. "A74586SNO7: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
  2. MeSH. "Purinergic P2Y Receptor Antagonists". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. European Chemicals Agency - ECHA. "Thieno[3,2-c]pyridine-5(4H)-acetic acid, α-(2-chlorophenyl)-6,7-dihydro-, methyl ester, (αS)-: The information provided here is aggregated from the "Notified classification and labelling" from ECHA's C&L Inventory. ". https://echa.europa.eu/information-o... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Clopidogrel are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Clopidogrel. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

2 consumers reported frequency of use

How frequently do I need to take Clopidogrel?
It was reported by ndrugs.com website users that Clopidogrel should ideally be taken Once in a day as the most common frequency of the Clopidogrel. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Clopidogrel should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Once in a day2
100.0%


2 consumers reported doses

What doses of Clopidogrel drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Clopidogrel drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Users%
51-100mg1
50.0%
1-5mg1
50.0%


Consumer reviews


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