Clopidogrel

Provider Level

Paramedic, Registered Nurse, Critical Care Paramedic, Critical Care Nurse, Physician Assistant, Advanced Practice Nurse, Physician

Class

Thienopyridine antiplatelet agent

Mechanism of Action

Irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface, preventing activation of the GPIIb/IIIa receptor complex and reducing platelet aggregation.

Indications

Acute coronary syndrome (STEMI, NSTEMI, unstable angina), recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Contraindications

Hypersensitivity to the drug, active pathological bleeding (such as peptic ulcer or intracranial hemorrhage).

Routes

PO

Onset / Duration

Onset: 1 to 2 hours. Duration: 5 to 7 days.

Adverse Effects

Bleeding, bruising, thrombotic thrombocytopenic purpura, rash, epistaxis.

Precautions & Interactions

Use with caution in patients at risk of increased bleeding from trauma, surgery, or other pathological conditions. Concomitant use of NSAIDs, anticoagulants, or other antiplatelet agents increases bleeding risk.

Special Considerations

Usually administered in conjunction with aspirin for acute coronary syndrome. Metabolized to its active form by CYP2C19; poor metabolizers may have reduced efficacy.