Clopidogrel summary

FeatureRecommendations, Effect
DosingLoading dose 300–900 mg, maintenance dose 75 mg daily
Time to onset5–6 Hours to reach maximal platelet inhibition but increasing doses achieve the same level of platelet inhibition more rapidly
MetabolismConverted to active form in the liver by the CYP450 system, most particularly enzymes 1A2, 2C19, and 3A4
ActionIrreversibly disables P2Y12 platelet receptor, preventing ADP-induced downstream conformational change of the GPIIb/IIIa receptor that is required for platelet activation
Interactions that increase potencyCigarette smoke (controversial)
Interactions that decrease potencyPPIs (controversial)
Side effectsHemorrhage, rash, pruritus, TTP
CostUS $103/month (2007)
  • Note:—TTP indicates thrombotic thrombocytopenic purpura.