DRUG OF THE DAY
clopidogrel
Thienopyridine P2Y12 platelet inhibitor
Before opening the card, recall one use, one safety check and one counseling point.
Reveal the drug learning card
Names and formulations
- Plavix: oral tablet
A loading dose is used for selected acute coronary syndrome scenarios; maintenance dosing and aspirin co-therapy depend on indication.
Common use
Reduces atherothrombotic events in acute coronary syndrome and in patients with recent myocardial infarction, recent ischemic stroke, or established peripheral arterial disease.
Mechanism of action
A prodrug whose active metabolite irreversibly inhibits platelet P2Y12 ADP receptors, preventing activation of the GPIIb/IIIa complex.
Important adverse effects and monitoring
- Boxed warning: patients with two CYP2C19 loss-of-function alleles have reduced activation and antiplatelet effect.
- Monitor for bleeding; premature discontinuation can increase cardiovascular risk.
- Rare thrombotic thrombocytopenic purpura requires urgent evaluation.
Patient counseling
- Do not stop before a prescriber-directed plan, especially after coronary stent placement.
- Report unusual bleeding and tell clinicians or dentists before procedures.
Interaction to recognize
With: omeprazole or esomeprazole
Why it matters: CYP2C19 inhibition significantly reduces clopidogrel's antiplatelet activity.
Practical response: Avoid the combination; consider an acid-suppressing option with less CYP2C19 inhibition when clinically appropriate.
Check the original sources
- DailyMed — Plavix (clopidogrel) prescribing information
Sections: Boxed Warning; 1 Indications and Usage; 5 Warnings and Precautions; 7.2 CYP2C19 Inhibitors; 12.1 Mechanism of Action; 17 Patient Counseling Information. Source checked 2026-09-13.
Selected learning points; verify current labeling for the complete prescribing information.