Antiplatelets, clopidogrel

Clopidogrel is an antiplatelet drug used to reduce the blood clots formation in the blood vessels. By virtue of its antiplatelet property, it cuts down the risk of heart attack and stroke. Clopidogrel is also known under the trade name Plavix. Naturally, when a blood vessel gets injured, platelets get stimulated to produce chemicals which in turn attract other platelets to stick together forming a blood clot. Clopidogrel inhibits the platelets to stick together and thus prevents blood clot formation.

When is clopidogrel used?

Clopidogrel is a blood thinner used in several conditions like:

  • Acute coronary syndrome (unstable angina or heart attack)
  • Stroke or transient ischaemic attack (TIA, mini stroke)
  • After angioplasty (PCI) with coronary stent placement
  • As an alternative antiplatelet drug in patient who are intolerant to Aspirin

Clopidogrel and low-dose aspirin

Low dose aspirin and clopidogrel (or alternative such as prasugrel or ticagrelor) are often used for 12 months following a heart attack or insertion of coronary stent. The rationale for this combination is further reduction in risk of blood clotting, the downside is increased the risk of bleeding. The risk of bleeding increases with advancing age, liver and kidney disease, high blood pressure and history of stroke.

Interaction with proton pump inhibitors (PPI)

There has been a concern that proton pump inhibitors (PPI), used to protect stomach lining in people with history of gastric or duodenal ulcers, may inhibit the effect of clopidogrel. This applies mainly to PPI omeprazole whereas lansoprazole is considered safe in this situation.

Side effects

You may experience the following adverse effects if you are taking clopidogrel: bleeding, indigestion, stomach pain, black stools, nausea or vomiting, rarely neutropenia (low white blood cells).