Clopidogrel

Basic clopidogrel information

• INN (international nonproprietary name): Clopidogrel
• Brand names available in the United Kingdom: Plavix and multiple generic clopidogrel products
• ATC code: B01AC04
• Forms and dosages: Film-coated tablets 75 mg (maintenance) and 300 mg (loading dose)
• Manufacturers in the United Kingdom: Sanofi (Plavix) and generic manufacturers such as Teva, Mylan and Krka
• Registration status in the United Kingdom: Prescription-only medicine (POM)
• OTC / Rx classification: Prescription-only medicine (POM)

Everyday use and best practices

Clopidogrel is taken once daily. The choice of morning or evening can be tailored to fit personal routines.

Take it at the same time each day, which helps to maintain its antiplatelet effect. Here are some tips:

• Find a time that suits your lifestyle.
• Set reminders on your phone to help you remember.
• Make it part of another daily routine, such as brushing your teeth.

In terms of food and drink interactions, clopidogrel can be taken with or without food. Swallow the tablet with a glass of water. If you are unsure about food or drink while on clopidogrel, ask a healthcare professional.

Legal status in the UK

Clopidogrel is a prescription-only medicine (POM) in the UK.

What’s inside and how it works

Ingredients overview

The active ingredient in clopidogrel tablets is clopidogrel (as hydrogen sulfate or besilate salt), an antiplatelet agent. It prevents blood platelets from clumping together, which lowers the risk of blood clots, stroke and heart attacks in patients with cardiovascular disease.

Mechanism basics explained simply

Clopidogrel operates by blocking the P2Y12 receptor on the surface of platelets, thereby hindering their ability to aggregate. By inhibiting this pathway, clopidogrel decreases the chances of clot formation, facilitating improved blood flow to vital organs like the heart and brain. Clopidogrel is a prodrug that is activated in the liver.

Main indications

Approved uses (MHRA listing)

Clopidogrel is licensed in the UK for preventing atherothrombotic events, including in:

• Patients with a recent myocardial infarction (heart attack).
• Patients with a recent ischaemic stroke.
• Patients with established peripheral arterial disease (PAD).
• Acute coronary syndrome, including patients undergoing percutaneous coronary intervention (PCI) with stent placement, usually together with aspirin.

Off-label uses in UK clinics

Clopidogrel is sometimes prescribed outside its licensed indications, based on individual patient needs, for example:

• Recurrent transient ischaemic attacks (TIAs).
• Dual antiplatelet therapy with aspirin in selected high-risk patients.

It's essential for patients to discuss these off-label uses with healthcare providers to understand the rationale behind their prescription.

Interaction warnings

Food interactions (alcohol)

• Alcohol: Consumption increases the risk of gastrointestinal bleeding. It is advisable to limit or avoid alcohol while on clopidogrel.
• Tea and coffee have no important interaction with clopidogrel.

Drug conflicts

Clopidogrel interacts with several medicines. Important points include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) can enhance bleeding risk.
• Concomitant use of other antiplatelet medications or anticoagulants may also heighten the risk of serious complications.
• Omeprazole and esomeprazole can reduce the effect of clopidogrel and should be avoided.

Patients should ensure they inform their healthcare providers of all medications they are currently taking, including over-the-counter medicines and supplements, to mitigate these risks. Suspected side effects can be reported through the Yellow Card scheme.