Clopidogrel

Clopidogrel — sold under the brand name Plavix, among others — is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy). It is taken by mouth. Its effect starts about two hours after intake and lasts for five days. Common side effects include headache, nausea, easy bruising, itching, and heartburn. More severe side effects include bleeding and thrombotic thrombocytopenic purpura. While there is no evidence of harm from use during pregnancy, such use has not been well studied. Clopidogrel is in the thienopyridine-class of antiplatelets. It works by irreversibly inhibiting a receptor called P2Y12 on platelets. Clopidogrel was patented in 1982, and approved for medical use in 1997. It is on the World Health Organization's List of Essential Medicines. In 2020, it was the 29th most commonly prescribed medication in the United States, with more than 19 million prescriptions. It is available as a generic medication. Clopidogrel is used to prevent heart attack and stroke in people who are at high risk of these events, including those with a history of myocardial infarction and other forms of acute coronary syndrome, stroke, and those with peripheral artery disease. Treatment with clopidogrel or a related drug is recommended by the American Heart Association and the American College of Cardiology for people who: Present for treatment with a myocardial infarction with ST-elevation including A loading dose given in advance of percutaneous coronary intervention (PCI), followed by a full year of treatment for those receiving a vascular stent A loading dose given in advance of fibrinolytic therapy, continued for at least 14 days Present for treatment of a non-ST elevation myocardial infarction or unstable angina Including a loading dose and maintenance therapy in those receiving PCI and unable to tolerate aspirin therapy Maintenance therapy for up to 12 months in those at medium to high risk for which a noninvasive treatment strategy is chosen In those with stable ischemic heart disease, treatment with clopidogrel is described as a "reasonable" option for monotherapy in those who cannot tolerate aspirin, as is treatment with clopidogrel in combination with aspirin in certain high risk patients.