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Clopidogrel
Aka: Clopidogrel, Plavix, Thienopyridine, Thiophene, Prasugrel, Effient
- See Also
- Antiplatelet Therapy for Vascular Disease
- Mechanism: Thienopyridine Class
- Blocks Platelet ADP
- Inhibits platelet aggregation
- Indications
- Cerebrovascular Accident Prevention
- Coronary Artery Disease Prevention
- Post-ST Elevation MI (with or without perfusion)
- Preparations
- Clopidogrel (Plavix)
- Prasugrel (Effient)
- Pending FDA approval in Summer 2008
- More effective than Plavix in cardiovascular event reduction
- Higher risk of bleeding than Plavix in age >75 years, weight <60 kg, CVA history
- Wiviott (2007) N Engl J Med 357(20):2001-15
- Advantages: Clopidogrel
- Less adverse effects than Ticlid
- Less GI Bleeding than Aspirin
- Option if GI Bleeding occurs with Aspirin
- Switch to Plavix does not prevent recurrent GI Bleed
- GI Bleed occurs in 8% of those switched to Plavix
- Consider adding PPI to Aspirin instead of Plavix
- Disadvantages
- Expensive ($125/month)
- Dosing
- Plavix 75 mg orally daily (consider initial 300 mg loading dose if age <75 years)