clopidogrel

Brand: Plavix

Prototype Drug
Drug Class: antiplatelet
Drug Family: antiplatelet
Subclass: P2Y12 ADP receptor antagonist (thienopyridine prodrug)
Organ Systems: cardiovascular

Mechanism of Action

Prodrug activated by CYP2C19 (and CYP3A4); active thiol metabolite irreversibly alkylates P2Y12 receptor preventing ADP-mediated platelet aggregation.

P2Y12 ADP receptor on platelets

Indications

  • ACS with DAPT (dual antiplatelet therapy)
  • stroke/TIA prevention
  • PAD
  • PCI stent thrombosis prevention

Contraindications

  • active pathological bleeding
  • severe hepatic impairment

Adverse Effects

Common

  • bleeding
  • rash
  • GI upset

Serious

  • major hemorrhage
  • TTP (rare)
  • neutropenia (rare)

Pharmacokinetics (ADME)

Absorption 50% absorbed; CYP2C19-dependent activation
Distribution irreversible platelet binding
Metabolism hepatic CYP2C19 (primary), CYP3A4
Excretion renal 50%, fecal 46%
Half-life 7-10 days (platelet lifespan)
Onset peak active metabolite 6h
Peak peak effect 6h
Duration 7-10 days
Protein Binding 98%
Vd variable

Drug Interactions

Drug / Agent Mechanism Severity
omeprazole/esomeprazole CYP2C19 inhibition reduces active metabolite generation — may reduce efficacy moderate
aspirin synergistic antiplatelet (DAPT) beneficial
NSAIDs additive bleeding risk major

Nursing Considerations

  1. CYP2C19 poor metabolizers (15-20% of Asians, 2-4% Caucasians) have reduced antiplatelet effect — consider genotyping or alternative agent
  2. Hold 5-7 days before elective surgery (platelet regeneration time)
  3. Avoid omeprazole (use pantoprazole or famotidine if PPI needed with clopidogrel)
  4. DAPT: aspirin + clopidogrel for 12 months post-ACS/DES stent

Clinical Pearls

  • Prodrug requiring CYP2C19 activation — poor metabolizers (loss-of-function alleles *2, *3) have reduced efficacy
  • CURE trial: clopidogrel + aspirin reduced CV events in NSTEMI
  • COMMIT/CLARITY-TIMI 28: benefit in STEMI

Safety Profile

Pregnancy use-with-caution
Lactation avoid
Renal Adjustment Not required
Hepatic Adjustment Required
TDM Not required

Concordance Terms

Cross-referenced clinical concepts — click any term to see all content where it appears.