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Clopidogrel bisulfate
Clopidogrel bisulfate(Plavix)
Clopidogrel bisulfate
(kloh-PID-oh-grel)
Pregnancy Category: B Plavix (Rx)

Classification: Antiplatelet drug

Action/Kinetics: Inhibits platelet aggregation by inhibiting binding of adenosine diphosphate (ADP) to its platelet receptor and subsequent ADP-mediative activation of glycoprotein GPIIb/IIIa complex. Modifies receptor irreversibly; thus, platelets are affected for remainder of their lifespan. Also inhibits platelet aggregation caused by agonists other than ADP by blocking amplification of platelet activation by released ADP. Rapidly absorbed from GI tract; food does not affect bioavailability. Peak plasma levels: About 1 hr. Extensively metabolized in liver; about 50% excreted in urine and 46% in feces. t1/2, elimination: 8 hr.

Uses: Reduction of MI, stroke, and vascular death in clients with atherosclerosis documented by recent stroke, MI, or established peripheral arterial disease.

Contraindications: Lactation. Active pathological bleeding such as peptic ulcer or intracranial hemorrhage.

Special Concerns: Use with caution in those at risk of increased bleeding from trauma, surgery, or other pathological conditions. Safety and efficacy have not been determined in children.

Side Effects: CV: Edema, hypertension, intracranial hemorrhage. GI: Abdominal pain, dyspepsia, diarrhea, nausea, hemorrhage, ulcers (peptic, gastric, duodenal). CNS: Headache, dizziness, depression. Body as a whole: Chest pain, accidental injury, flu-like symptoms, pain, fatigue. Respiratory: URTI, dyspnea, rhinitis, bronchitis, coughing. Hematologic: Purpura, epistaxis. Musculoskeletal: Arthralgia, back pain. Dermatologic: Disorders of skin/appendages, rash, pruritus. Miscellaneous: UTI.

Laboratory Test Alterations: Hypercholesterolemia.

Drug Interactions: Evening primrose oil / Potential for antiplatelet effect Feverfew / Potential for antiplatelet effect Garlic / Potential for antiplatelet effect Ginger / Potential for antiplatelet effect Ginkgo biloba / Potential for antiplatelet effect Grapeseed extract / Potential for antiplatelet effect NSAIDs / Risk of occult blood loss Warfarin / Clopidogrel prolongs bleeding time; safety of use with warfarin not established