How long does it take For clopidogrel to work?
Some inhibition of platelet clotting is seen within two hours of taking the drug; however, it takes between three to seven days of regular clopidogrel dosing to reach its maximal effect. Bleeding time and platelet aggregation return to baseline values within 5 days of treatment discontinuation.
Do patients respond adequately to clopidogrel?
Increasing experience indicates that a significant proportion of patients do not respond adequately to clopidogrel. Because failure of antiplatelet therapy can have severe consequences, there is need for a reliable assay to quantify the effectiveness of clopidogrel treatment.
Does clopidogrel affect cartridge closure time in platelet function analyzer?
In this study, we observed no significant effect of clopidogrel on cartridge closure time, an indicator of blood clotting, when we used epinephrine/collagen- and ADP/collagen-coated cartridges in a platelet function analyzer.
How does clopidogrel work to prevent blood clots?
It works by keeping the platelets in the blood from sticking together, thereby preventing blood clots that can occur with certain cardiovascular conditions. Clopidogrel is sold under the brand name Plavix and as generics. Clopidogrel increases the risk of bleeding.
What monitoring is required for clopidogrel?
Most clinical studies on clopidogrel rely on standard platelet aggregometry to measure inhibition of ADP-induced aggregation (4)(5). In addition to aggregometry, cytometric determination of surface expression of platelet proteins, in particular P-selectin (CD62P), is commonly used to monitor platelet activation.
How long should you hold clopidogrel before surgery?
Although aspirin can be continued in patients undergoing cardiac surgery, clopidogrel should be stopped at least 5 days before the procedure when the surgery is scheduled and the risk of ischaemia is low.
Why clopidogrel should be stopped before OT?
Clopidogrel cessation less than 7 days before an abdominal operation significantly increases the risk of postoperative bleeding requiring transfusion; however, it does not appear to increase the risk of life-threatening morbidity or mortality after controlling for the urgency of operative intervention.
How do you measure effectiveness of Plavix?
Test results are in P2Y12 reaction units (PRU). This test measures the extent of platelet aggregation in the presence of P2Y12 inhibitor drugs such as clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta) and ticlopidine (Ticlid).
When can I resume clopidogrel after surgery?
For elective procedures, surgery should be postponed until the end of the indication for clopidogrel. After the operation, clopidogrel should be resumed within the 12-24 h.
When should clopidogrel and Aspirin be stopped before surgery?
Conclusions Aspirin use should not be stopped in the perioperative period unless the risk of bleeding exceeds the thrombotic risk from withholding the drug. With the exception of recent drug-eluting stent implantation, clopidogrel bisulfate use should be stopped at least 5 days prior to most elective surgery.
How long before surgery should the drug clopidogrel be stopped so that its effect disappears and risk of bleeding is?
Despite the prevalence of surgical candidates on clopidogrel, no definitive guidelines exist for stopping the drug preoperatively. A 7 day off-clopidogrel period is commonly considered safe with regards to bleeding complications.
Should clopidogrel be stopped before CABG?
So, for patients scheduled for CABG, the recommendation is to stop clopidogrel at least 5 days and, preferably, 10 days prior to surgery to minimize blood loss. In the case of aspirin, the recommendation is to maintain it up to surgery and beyond the time of surgery.
What is the half-life of clopidogrel?
After a single, oral dose of 75 mg, clopidogrel has a half-life of approximately 6 hours. The elimination half-life of the inactive acid metabolite was 8 hours after single and repeated administration. Covalent binding to platelets accounted for 2% of radiolabel with a half-life of 11 days.
How do you monitor antiplatelet therapy?
Flow cytometry assays can measure circulating activated platelets, in vitro platelet activation, and platelet–leucocyte interactions, to diagnose inherited or acquired platelet disorders, monitor antiplatelet therapy, and so on.
Which laboratory test result should you check before beginning the clopidogrel therapy?
Conclusion: The flow cytometric VASP-assay, the VerifyNow P2Y12 assay and, although to a lesser extent, 20 micromol L(-1) ADP-induced LTA correlate best with the maximal plasma level of the AMC, suggesting these may be the preferred platelet function tests for monitoring the responsiveness to clopidogrel.
Do you check PT INR with Plavix?
The PT/INR is prolonged by the new direct oral anticoagulants rivaroxaban (Xarelto) and apixaban (Eliquis), and the PTT is prolonged by the direct thrombin inhibitor dabigatran (Pradaxa). Neither test is prolonged by the antiplatelet drugs aspirin, Plavix, prasugrel, or ticagrelor.
Before Taking This Medicine
You should not use clopidogrel if you are allergic to it, or if you have: 1. any active bleeding; or 2. a stomach ulcer or bleeding in the brain (s...
How Should I Take Clopidogrel?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use these medicines exactly as directed.Clop...
What Happens If I Miss A Dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What Happens If I Overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.
What Should I Avoid While Taking Clopidogrel?
Avoid alcohol. It can increase your risk of stomach bleeding.Avoid activities that may increase your risk of bleeding or injury. Use extra care to...
Clopidogrel Dosing Information
Usual Adult Dose for Acute Coronary Syndrome:Unstable Angina (UA)/Non-ST-Elevation Myocardial Infarction (NSTEMI):-Loading dose: 300 mg orally once...
What Other Drugs Will Affect Clopidogrel?
Certain other medicines may increase your risk of bleeding, including aspirin. Avoid taking aspirin unless your doctor tells you to.Tell your docto...
What is clopidogrel used for?
Clopidogrel is used to lower your risk of having a stroke, blood clot, or serious heart problem after you've had a heart attack, severe chest pain ( angina ), or circulation problems. Clopidogrel may also be used for purposes not listed in this medication guide.
How to prevent bleeding while shaving?
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth. If you also take aspirin: Ask a doctor or pharmacist before using medicines for pain, fever, swelling, or cold/flu symptoms.
Can you take clopidogrel if you have a stomach ulcer?
You should not use clopidogrel if you have any active bleeding such as a stomach ulcer or bleeding in the brain. Clopidogrel increases your risk of bleeding, which can be severe or life-threatening.
Can you breastfeed while taking Clopidogrel?
Tell your doctor if you are pregnant or plan to become pregnant. You should not breastfeed while using this medicine.
Can you take all your medications at the same time?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tell your doctor about all your other medicines, especially:
Can you take Clopidogrel if you are allergic to it?
You should not use clopidogrel if you are allergic to it, or if you have: any active bleeding; or. a stomach ulcer or bleeding in the brain (such as from a head injury ). Tell your doctor if you have ever had: an ulcer in your stomach or intestines; or. a bleeding disorder or blood clotting disorder.
What is clopidogrel used for?
Clopidogrel is an antiplatelet blood-thinning medicine that may help prevent future heart attacks, strokes, and other clot-related diseases in patients who have already had a heart attack, stroke, or have certain cardiovascular conditions.
What are the side effects of clopidogrel?
Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). Other common side effects of clopidogrel can include shortness of breath.
How long is clopidogrel plus aspirin?
Trials included in the meta-analyses had a clopidogrel plus aspirin arm (long term was 12 months or longer), a comparator arm of either aspirin alone or short-term clopidogrel plus aspirin (6 months or less), and had a planned follow-up of at least one year.
How long does a dual antiplatelet therapy last?
The Dual Antiplatelet Therapy (DAPT) 1 trial was a randomized, double-blind, placebo-controlled trial that compared antiplatelet treatment for 30 months vs. 12 months following percutaneous coronary intervention and placement of a drug-eluting stent. After stent placement, patients received 12 months of dual antiplatelet therapy consisting of aspirin plus either clopidogrel (Plavix) or prasugrel (Effient) and then were randomized to continued treatment for 18 additional months of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel) or to aspirin plus placebo. The investigators selected the antiplatelet agents patients received, with about two-thirds receiving clopidogrel and one-third receiving prasugrel. Acute coronary syndrome was the indication for the stent in about 46% of patients.
What is the best antiplatelet medicine for a heart attack?
Health care professionals should consider the benefits and risks of available antiplatelet medicines before starting treatment. Clopidogrel is an antiplatelet medicine used to prevent blood clots in patients who have had a heart attack, stroke, or problems with the circulation in the arms and legs.
How does DAPT work?
It works by helping to keep the platelets in the blood from sticking together and forming clots that can occur with certain medical conditions. Results from the DAPT trial were published in the New England Journal of Medicine in November 2014.
Does Plavix change the risk of death?
FDA Drug Safety Communication: FDA review finds long-term treatment with blood-thinning medicine Plavix (clopidogrel) does not change risk of death. This is an update to the FDA Drug Safety Communication: FDA Reviews Long-Term Antiplatelet Therapy as Preliminary Trial Data Show Benefits but a Higher Risk of Non-Cardiovascular Death issued on ...
Is there a standard assay for clopidogrel?
Typically, inhibition of platelet aggregation, secretion, or adhesion is considered a marker of drug action, but there is no standard, accepted assay for clopidogrel efficacy. For that reason, the magnitude of clopidogrel resistance and the variability of platelet responses to clopidogrel remain uncertain.
Is clopidogrel a potent drug?
Background: Clopidogrel is a potent drug for prevention of adverse effects during and after coronary intervention. Increasing experience indicates that a significant proportion of patients do not respond adequately to clopidogrel.
How it works
Clopidogrel belongs to a class of drugs called platelet inhibitors or thienopyridine class inhibitors of P2Y12 ADP platelet receptors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Diabetes drug
In most cases, repaglinide should not be taken with clopidogrel. Taking these drugs together increases the amount of repaglinide in your body, which can result in low blood sugar levels. If you must take these drugs together, your doctor will carefully manage your dosage of repaglinide.
Stomach acid drugs (proton pump inhibitors)
You shouldn’t take clopidogrel with drugs used to treat stomach acid. They can make clopidogrel less effective. Examples of these drugs include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Taking clopidogrel with NSAIDs may increase your risk of bleeding in your stomach and intestines. Examples of these drugs include:
Blood thinners
Warfarin and clopidogrel work to thin the blood in different ways. Taking them together increases your risk of bleeding.
Drugs used to treat depression
Using certain antidepressants with clopidogrel may increase your risk of bleeding. Examples of these drugs include:
How It Works
Upsides
Downsides
- If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: 1. An increased risk of bleeding from any wound, nosebleeds, blood in the urine, and an increased likelihood of bruising are the most commonly reported side effects. 2. May also cause muscle pain, taste disorders, rash, an…
Bottom Line
- Clopidogrel may be given to reduce the risk of a heart attack or stroke in certain cardiovascular conditions or following a heart attack or ischemic stroke. People who are poor metabolizers at CYP2C19 may not respond very well to clopidogrel. Bleeding is the main side effect of clopidogrel.
Tips
- May be taken with or without food.
- Take exactly as prescribed and do not discontinue except on a doctor's advice.
- Clopidogrel is often taken in conjunction with aspirin. Your doctor will advise you if you need to take aspirin as well.
- Do not take omeprazole or esomeprazole while taking clopidogrel as these will reduce its act…
- May be taken with or without food.
- Take exactly as prescribed and do not discontinue except on a doctor's advice.
- Clopidogrel is often taken in conjunction with aspirin. Your doctor will advise you if you need to take aspirin as well.
- Do not take omeprazole or esomeprazole while taking clopidogrel as these will reduce its activity. Talk to a pharmacist or your doctor before buying any over-the-counter medicine to check if it is...
Response and Effectiveness
- Clopidogrel is rapidly absorbed but has to undergo metabolism via CYP2C19 enzymes in the liver to its active form. People who are poor metabolizers at CYP2C19 will have a poor response to clopidogrel.
- Even though the active form of clopidogrel doesn't last for very long in the body, its effect on platelets lasts for the lifetime of the platelet. (7 to 10 days). Some inhibition of platelet clotti...
- Clopidogrel is rapidly absorbed but has to undergo metabolism via CYP2C19 enzymes in the liver to its active form. People who are poor metabolizers at CYP2C19 will have a poor response to clopidogrel.
- Even though the active form of clopidogrel doesn't last for very long in the body, its effect on platelets lasts for the lifetime of the platelet. (7 to 10 days). Some inhibition of platelet clotti...
- If the antiplatelet effect of clopidogrel needs to be reversed, platelet transfusions may be administered. However, these are less effective if given within 4 hours of a loading dose or 2 hours of...
Interactions
- Medicines that interact with clopidogrel may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with clopidogrel. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions sh…
Further Information
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use clopidogrel only for the indication prescribed. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Copyright 1996-2022 Drugs.com. Revision date: November 3, 2021. Medical Dis…