Clopidogrel

Chemical formula: C₁₆H₁₆ClNO₂S Molecular mass: 321.822 g/mol PubChem compound: 60606

Therapeutic indications

Clopidogrel is indicated for:

ST segment elevation acute myocardial infarction in medically treated patients

Population group: only adults (18 years old or older)

ST segment elevation acute myocardial infarction, in combination with ASA in medically treated patients eligible for thrombolytic/fibrinolytic therapy.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

For patients <75 yearls old 300 mg loading dose and thereafter 75 mg once daily, and for patients ≥75 years old 75 mg once daily

Moderate to high-risk Transient Ischemic Attack (TIA) or minor Ischemic Stroke (IS)

Population group: only adults (18 years old or older)

Clopidogrel in combination with ASA is indicated in adult patients with moderate to high-risk TIA (ABCD2¹ score ≥4) or minor IS (NIHSS² ≤3) within 24 hours of either the TIA or IS event.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

300 mg as loading dose and thereafter 75 mg once daily for 21 days

Recent myocardial infarction, ischemic stroke or established peripheral arterial disease

Population group: only adults (18 years old or older)

Clopidogrel is indicated in adult patients suffering from myocardial infarction (from a few days until less than 35 days), ischemic stroke (from 7 days until less than 6 months) or established peripheral arterial disease.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

75 mg once daily

Non-ST segment elevation acute coronary syndrome

Population group: only adults (18 years old or older)

Non-ST segment elevation acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction), including patients undergoing a stent placement following percutaneous coronary intervention, in combination with acetylsalicylic acid (ASA).

For this indication, competent medicine agencies globally authorize below treatments (click for details):

300 mg or 600 mg loading dose and thereafter 75 mg once daily

Prevention of atherothrombotic and thromboembolic events in atrial fibrillation

Population group: only adults (18 years old or older)

In adult patients with atrial fibrillation who have at least one risk factor for vascular events, are not suitable for treatment with Vitamin K antagonists (VKA) and who have a low bleeding risk, clopidogrel is indicated in combination with ASA for the prevention of atherothrombotic and thromboembolic events, including stroke.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

75 mg once a day

Contraindications

Clopidogrel is contraindicated in the following cases:

Severe hepatic impairment

Hepatic failure stage IV

Active pathological bleeding

at least one of

Bleeding
Peptic ulcer
Gastrointestinal hemorrhage
Intracranial hemorrhage

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