Individual generic drug information

clopidogrel

Reference monograph

Part of registered formulation

CLOPIDOGREL

Reference record: Clopidogrel
Source: BNF 80 (2020–2021)
Printed source pages: 153, 154
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Clopidogrel only.

Indications And Dose

Prevention of atherothrombotic events in percutaneous coronary intervention (adjunct with aspirin) in patients not already on clopidogrel ▶BY MOUTH ▶Adult: Loading dose 300 mg, to be taken prior to the procedure, alternatively loading dose 600 mg, higher dose may produce a greater and more rapid inhibition of platelet aggregation Transient ischaemic attack for patients with aspirin hypersensitivity, or those intolerant of aspirin despite the addition of a proton pump inhibitor | Acute ischaemic stroke for patients with aspirin hypersensitivity, or those intolerant of aspirin despite the addition of a proton pump inhibitor ▶BY MOUTH ▶Adult: 75 mg once daily Prevention of atherothrombotic events in peripheral arterial disease or within 35 days of myocardial infarction, or within 6 months of ischaemic stroke ▶BY MOUTH continued → ▶Adult: 75 mg once daily Prevention of atherothrombotic events in acute coronary syndrome without ST-segment elevation (given with aspirin) ▶BY MOUTH Cardiovascular system ▶Adult: Initially 300 mg, then 75 mg daily for up to 12 months Prevention of atherothrombotic events in acute myocardial infarction with ST-segment elevation (given with aspirin) ▶BY MOUTH ▶Adult 18–75 years: Initially 300 mg, then 75 mg for at least 4 weeks ▶Adult 76 years and over: 75 mg daily for at least 4 weeks Prevention of atherothrombotic and thromboembolic events in patients with atrial fibrillation and at least one risk factor for a vascular event (with aspirin) and for whom warfarin is unsuitable ▶BY MOUTH ▶Adult: 75 mg once daily l UNLICENSED USE 600 mg loading dose prior to percutanous coronary intervention is an unlicensed dose. Use in transient ischaemic attack or acute ischaemic stroke, in patients with aspirin hypersensitivity or intolerant of aspirin, is unlicensed.

Source pages 153, 154

Contra Indications

Active bleeding

Source page 154

Cautions

Discontinue 7 days before elective surgery if antiplatelet effect not desirable. patients at risk of increased bleeding from trauma, surgery, or other pathological conditions CAUTIONS, FURTHER INFORMATION ▶Elderly Prescription potentially inappropriate (STOPP criteria) with concurrent signiﬁcant bleeding risk, such as uncontrolled severe hypertension, bleeding diathesis or recent non-trivial spontaneous bleeding (high risk of bleeding). See also Prescribing in the elderly p. 33.

Source page 154

Allergy And Cross Sensitivity

Caution with history of hypersensitivity reactions to thienopyridines (e.g. prasugrel).

Source page 154

National Funding Access Decisions

NICE decisions ▶Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (December 2010) NICE TA210 The guidance applies to patients who have had an occlusive vascular event, or who have established peripheral arterial disease. The guidance does not apply to patients who have had, or are at risk of, stroke associated with atrial ﬁbrillation, or who need prophylaxis for occlusive events following coronary revascularisation or carotid artery procedures. Clopidogrel monotherapy is recommended as an option to prevent occlusive vascular events in patients who have had: . an ischaemic stroke, or who have peripheral arterial disease or multivascular disease, or . a myocardial infarction, only if aspirin is contra- indicated or not tolerated. www.nice.org.uk/guidance/ta210 Scottish Medicines Consortium (SMC) decisions SMC No. 88/04 The Scottish Medicines Consortium has advised (March 2004) that clopidogrel (Plavix ®) is accepted for restricted use within NHS Scotland for the treatment of conﬁrmed acute coronary syndrome (without ST-segment elevation), in combination with aspirin. Clopidogrel should be initiated in hospital inpatients only. SMC No. 390/07 The Scottish Medicines Consortium has advised (August 2007) that clopidogrel (Plavix ®) is accepted for restricted use within NHS Scotland for patients with ST-segment elevation acute myocardial infarction in combination with aspirin; treatment with clopidogrel is restricted to 4 weeks only.

Source page 154

Safety

Extracted information for Clopidogrel only.

Interactions

→Appendix 1: clopidogrel

Source page 154

Side Effects

▶Common or very common Diarrhoea. gastrointestinal discomfort. haemorrhage. skin reactions ▶Uncommon Constipation. dizziness. eosinophilia. gastrointestinal disorders. headache. intracranial haemorrhage. leucopenia. nausea. paraesthesia. thrombocytopenia. vomiting ▶Rare or very rare Acquired haemophilia. agranulocytosis. anaemia. angioedema. arthralgia. arthritis. bone marrow disorders. confusion. fever. glomerulonephritis. gynaecomastia. hallucination. hepatic disorders. hypersensitivity. hypotension. myalgia. neutropenia. pancreatitis. respiratory disorders. severe cutaneous adverse reactions (SCARs). stomatitis. taste altered. ulcerative colitis. vasculitis. vertigo. wound haemorrhage ▶Frequency not known Kounis syndrome

Source page 154

Pregnancy

Manufacturer advises avoid—no information available.

Source page 154

Breast Feeding

Manufacturer advises avoid.

Source page 154

Hepatic Impairment

Manufacturer advises caution in moderate impairment in patients with an increased risk of bleeding—limited information available; avoid in severe impairment.

Source page 154

Renal Impairment

Manufacturer advises caution.

Source page 154

Dose and formulations

Extracted information for Clopidogrel only.

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet ▶Clopidogrel (Non-proprietary) Clopidogrel 75 mg Clopidogrel 75mg tablets | 28 tablet P £35.31 DT = £1.48 | 30 tablet P £1.59–£36.95 ▶Plavix (Sanofi) Clopidogrel 75 mg Plavix 75mg tablets | 30 tablet P £35.64 Clopidogrel (as Clopidogrel hydrogen sulfate) 300 mg Plavix 300mg tablets | 30 tablet P £142.54 DT = £142.54

Source page 154

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Loading dose 300 mg, to be taken prior to the

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

Initially 300 mg, then 75 mg daily for up to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

Initially 300 mg, then 75 mg for at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

75 mg daily for at least 4 weeks

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.

Individual generic drug information

clopidogrel

Reference monograph

Part of registered formulation

CLOPIDOGREL

Reference record: Clopidogrel
Source: BNF 80 (2020–2021)
Printed source pages: 153, 154
Age groups indexed: 1

Individual active ingredientSource records are displayed separately

Some source sections could not be separated reliably in the extraction. Review the printed source pages when a field is missing or incomplete.

Overview

Extracted information for Clopidogrel only.

Indications And Dose

Source pages 153, 154

Contra Indications

Active bleeding

Source page 154

Cautions

Source page 154

Allergy And Cross Sensitivity

Caution with history of hypersensitivity reactions to thienopyridines (e.g. prasugrel).

Source page 154

National Funding Access Decisions

Source page 154

Safety

Extracted information for Clopidogrel only.

Interactions

→Appendix 1: clopidogrel

Source page 154

Side Effects

Source page 154

Pregnancy

Manufacturer advises avoid—no information available.

Source page 154

Breast Feeding

Manufacturer advises avoid.

Source page 154

Hepatic Impairment

Manufacturer advises caution in moderate impairment in patients with an increased risk of bleeding—limited information available; avoid in severe impairment.

Source page 154

Renal Impairment

Manufacturer advises caution.

Source page 154

Dose and formulations

Extracted information for Clopidogrel only.

Medicinal Forms

Source page 154

Dose text by age group

Filter the extracted dose blocks for this individual drug.

Adults

First line only; read the complete Indications and dose section above.

Loading dose 300 mg, to be taken prior to the

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 153

Adults

First line only; read the complete Indications and dose section above.

Initially 300 mg, then 75 mg daily for up to

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

Initially 300 mg, then 75 mg for at

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

75 mg daily for at least 4 weeks

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Adults

First line only; read the complete Indications and dose section above.

75 mg once daily

This is a first-line fragment. Read the full Indications and Dose section above.

Candidate age grouping · source page 154

Age labels are extracted from the printed dose headings and require clinical review. Confirm current local guidance, dose, route, formulation, contraindications and interactions before prescribing.