Pharm 101: Clopidogrel

Class

Antiplatelet


Pharmacodynamics
  • Thienopyridine
  • Reduce platelet aggregation by inhibiting ADP pathway of platelets
  • Irreversibly inhibits ADP P2Y12 receptor on platelets for life of platelet
  • Unlike aspirin, no effect on prostaglandin metabolism

Pharmacokinetics
  • Prodrug
  • Hepatic metabolism to active and inactive metabolites
  • 80% of platelet activity inhibited within five hours of loading dose of 300mg
  • Effects lasts for life of platelet, duration of anti-platelet effect 7-10 days
  • Elimination half-life 30-60 minutes
  • Following oral dose, 50% excreted in urine and 46% in faeces in next five days

Clinical uses
  • Ischaemic heart disease including NSTEMI, STEMI, pre/post stent
  • Peripheral vascular disease
  • Stroke prevention
  • Dosage 75mg daily, or 300-600mg loading dose

Adverse effects
  • Gastrointestinal upset
  • Bleeding
  • Thrombotic thrombocytopenic purpura

Further Reading

Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU Emergency Medicine Trainee with interests in medical education, ECG interpretation, and the use of point-of-care ultrasound in the undifferentiated patient. Co-author of the LITFL ECG Library | Twitter

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