Clopidogrel: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
===[[Acute coronary syndrome]]=== | |||
*Unstable | *[[Unstable angina]], [[NSTEMI]]: Start 300 mg PO x 1, then 75 mg PO qd | ||
*[[STEMI]]: 75 mg/day PO (in combination with [[aspirin]] 162-325 mg/day | *[[STEMI]]: 75 mg/day PO (in combination with [[aspirin]] 162-325 mg/day | ||
*Recent MI, [[Stroke]], or [[Peripheral Arterial Disease]]: 75 mg PO qd | *Recent MI, [[Stroke]], or [[Peripheral Arterial Disease]]: 75 mg PO qd | ||
===Thrombotic event prevention=== | |||
*75 mg PO qd | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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*bleeding, severe, | *bleeding, severe, | ||
*hemorrhage | *hemorrhage | ||
*TTP | *[[TTP]] | ||
*agranulocytosis | *agranulocytosis | ||
*hypersensitivity | *hypersensitivity reaction | ||
*anaphylactoid | *anaphylactoid reaction | ||
*Stevens-Johnson syndrome | *[[Stevens-Johnson syndrome]] | ||
*toxic epidermal necrolysis | *[[toxic epidermal necrolysis]] | ||
*erythema multiforme | *[[erythema multiforme]] | ||
*drug rash | *drug rash with eosinophilia and systemic sx | ||
*pneumonia | *Eosinophilic pneumonia | ||
===Common=== | ===Common=== | ||
Revision as of 13:13, 4 August 2015
General
- Type: Antiplatelet
- Dosage Forms: 75, 300 PO
- Common Trade Names: Plavix
Adult Dosing
Acute coronary syndrome
- Unstable angina, NSTEMI: Start 300 mg PO x 1, then 75 mg PO qd
- STEMI: 75 mg/day PO (in combination with aspirin 162-325 mg/day
- Recent MI, Stroke, or Peripheral Arterial Disease: 75 mg PO qd
Thrombotic event prevention
- 75 mg PO qd
Pediatric Dosing
- Not Recommended
Special Populations
- Pregnancy Rating: B
- Lactation: Safety Unknown
- Renal Dosing
- Adult: not defined
- Pediatric
- Hepatic Dosing
- Adult: no adjustment
- Pediatric
Contraindications
- Allergy to class/drug
- active bleeding
- caution if trauma
- caution if elective surgery w/in 5 days
- caution if GI disorder
- caution if ocular dz
- caution if poor or intermediate CYP2C19 metabolizer
- caution if renal impairment, mod-severe
Adverse Reactions
Serious
- bleeding, severe,
- hemorrhage
- TTP
- agranulocytosis
- hypersensitivity reaction
- anaphylactoid reaction
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- erythema multiforme
- drug rash with eosinophilia and systemic sx
- Eosinophilic pneumonia
Common
- bleeding
- pruritus
Pharmacology
- Half-life: 8h
- Metabolism: liver, CYP450: 1A2, 2C9, 2C19 (primary), 3A4 substrate
- Excretion: urine 50%, feces 46%
- Mechanism of Action: irreversibly binds to P2Y12 adenosine diphosphate receptors, reducing platelet activation and aggregation