The P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are administered in fixed doses without laboratory monitoring. Randomized trials in acute coronary syndrome have shown that prasugrel and ticagrelor are more effective than standard-dose clopidogrel. Nonetheless, standard-dose clopidogrel remains widely used because it causes less bleeding and is less expensive. Patients treated with...

Clopidogrel, a thienopyridine inhibitor of the platelet P2Y12 adenosine diphosphate (ADP) receptor, has been widely used for the prevention of stent thrombosis in patients with acute coronary syndrome [1]. To exert an antiplatelet effect, clopidogrel requires conversion to an active thiol metabolite (15% of total metabolites) via the cytochrome P450 pathway (especially CYP2C19*2) [1,2]. But the...

The role of clopidogrel in disruption of platelet aggregation is well known. The variability in clopidogrel response is a well-documented phenomenon and has been widely addressed through pharmacogenomics. CYP2C19 has been considered as genetic predictor of clopidogrel response. Owing to the inter-individual variations, CPIC (Clinical Pharmacogenetics Implementation Consortium) had issued guidel...

The effect of concomitantly administered clopidogrel on anti-coagulation status was investigated in patients receiving long-term warfarin therapy. Forty-three patients with non-valvular atrial fibrillation who were receiving long-term warfarin and had a stable international normalized ratio (INR) between 2 and 3 were randomly assigned to clopidogrel 75 mg daily or placebo for 8 days (Days 1-8)....

CONTEXT Following percutaneous coronary intervention (PCI), short-term clopidogrel therapy in addition to aspirin leads to greater protection from thrombotic complications than aspirin alone. However, the optimal duration of combination oral antiplatelet therapy is unknown. Also, although current clinical data suggest a benefit for beginning therapy with a clopidogrel loading dose prior to PCI,...

BACKGROUND AND PURPOSE The purpose of this study was to determine safety and tolerability of clopidogrel in children with arterial ischemic stroke (AIS). Clopidogrel is the alternative antiplatelet medication when aspirin is not tolerated or fails. The possible risks and safety of clopidogrel in children with AIS have not been assessed. METHODS This is a prospective consecutive cohort study o...

The drug interaction between proton pump inhibitors and clopidogrel has been the subject of much study in recent years. Contradictory results regarding the effect of proton pump inhibitors on platelet reactivity and on clinical outcome in clopidogrel-treated patients have been reported in literature. Concomitant use of omeprazole and clopidogrel was found to decrease the exposure (AUC) to clopi...

OBjECTiVES 1. Describe the proposed mechanism of the interaction between clopidogrel and proton pump inhibitors. 2. Summarize the pharmacologic/pharmacodynamic evidence for the interaction between clopidogrel and proton pump inhibitors. 3. Summarize the clinical evidence for the interaction between clopidogrel and proton pump inhibitors. 4. Describe the food and Drug Administration’s updated wa...

In the Ticlid or Plavix Post-Stents (TOPPS) trial, 1016 patients undergoing successful coronary stent placement were randomized to receive aspirin and either ticlopidine or clopidogrel. In this trial, the dosages and regimens of ticlopidine and clopidogrel resembled more closely those used in most catheterization laboratories than did the two previous randomized trials comparing ticlopidine and...

Background-—The role of the CYP2C19 genotype on clopidogrel efficacy has been studied widely, with data suggesting reduced clopidogrel efficacy in loss-of-function variant carriers taking clopidogrel after percutaneous coronary intervention; however, data are limited regarding the association between CYP2C19 genetic variants and outcomes in stroke patients. We investigated whether CYP2C19 metab...