Clopidogrel 75mg : Uses, Dosage, Side Effects, Interactions & More

Clopidogrel belongs to a class of antiplatelet medicines approved for managing unstable angina (chest pain). Apart from it, this medicine serves other purposes as well. Learn more about the uses, dosage, side effects, special precautions, and more about Clopidogrel.

What is Clopidogrel 75 mg used for?

Clopidogrel 75mg is prescribed to adults to prevent atherothrombotic events, which occur when blood clots and hardening of the arteries develop. It can be used in the following populations:

• Patients who have recently had a heart attack. The treatment can usually be initiated between a few days and 35 days after the heart attack.
• Patients with a recent ischaemic stroke (stroke due to restricted blood supply to the part of the brain). The treatment can be initiated a week and six months after the stroke.
• Patients suffering from peripheral arterial disease (disturbed blood flow in the arteries).
• Patients with a condition called acute coronary syndrome should use Clopidogrel with aspirin (another medicine used for the prevention of blood clots), including those with a stent inserted in their artery to prevent it from closing. Clopidogrel can be prescribed to those who have a myocardial infarction accompanied by ST-segment elevation under a healthcare provider’s supervision. The medicine can also be prescribed to those patients; this abnormal reading does not appear on the ECG if they have unstable angina pectoris (a severe type of chest pain).

How is Clopidogrel used?

The standard dose of the medicine is one 75 mg tablet taken once a day, either before or after meals. In cases of acute coronary syndrome, the medicine is used in combination with aspirin, and treatment generally begins with four 75 mg tablets. This is followed by a 75 mg dose once daily for at least four weeks or up to twelve months. Deplatt is the generic version of the drug available at affordable prices compared to the brand drug.

Breastfeeding considerations:  

Use in children: There is no evidence to show the effectiveness and safety of this medicine in children.

Older patients: No dose adjustment is needed in this population. However, concomitant treatment should be evaluated to assess and minimise the risk of bleeding. 

How does Clopidogrel work?

The antiplatelet medicine works by preventing blood clots from forming. Blood clots occur when platelets, special cells in the blood, stick together. Clopidogrel prevents this sticking of cells by blocking a substance called ADP from adhering to a special receptor on its surface. This prevents the platelets from becoming sticky, reduces the risk of blood clot formation, and helps prevent another stroke or heart attack.

What are warnings and precautions?

Risk of bleeding: Clopidogrel 75 mg increases the risk of bleeding by inhibiting the adhesion of blood cells to platelets for their lifespan, typically 7 to 10 days. In such cases, platelet transfusions may be considered; however, they are less effective when used shortly after receiving the clopidogrel medication. Concomitant use of blood thinner medicines, antiplatelet agents, or NSAIDs further increases the risk.

Discontinuation of Clopidogrel 75 mg: Early discontinuation of this medicine increases the risk of heart-related problems. If temporary discontinuation is necessary, it should be restored as soon as hemostasis, a mechanism that stops bleeding from a blood vessel, is achieved. Treatment should be stopped five days before surgery to reduce the risk of bleeding. 

Cross-reactivity: Hypersensitivity reactions, which include angioedema, rash, or hematologic abnormalities, may occur with the use of Clopidogrel medicine, especially in patients with a history of similar responses to ticlopidine. In such cases, alternative therapies should be considered for these patients.

Thrombotic thrombocytopenic purpura (TTP)L:  It is a rare but serious condition defined by anaemia, thrombocytopenia, neurological signs and kidney function. This health condition requires immediate treatment. Early recognition and timely treatment are important to prevent death associated with this condition.

What are the side effects?

Bleeding is the most common side effect noticed in patients receiving Clopidogrel 75mg, and it can occur at varying degrees of severity at any site. Risk factors associated with bleeding include a recent bleeding event, an age older than 75, low body weight and use of medications (such as warfarin or non-steroidal anti-inflammatory agents) that may increase the risk of developing bleeding.

The other most commonly reported side effects include rash and pruritus. In the case of mild to moderate hypersensitivity, the patient can receive a steroid while maintaining the treatment. Other options for managing such conditions include sensitisation and switching to an alternative form of treatment. The unexpected events associated with this medicine include liver dysfunction and interstitial lung disease. Further research is needed to understand these side effects better and improve patient safety. Other adverse drug reactions include thrombocytopenia, bleeding risks, and gastrointestinal disturbances.

Conclusion

Clopidogrel is a widely recommended medicine by healthcare experts worldwide. While this medicine is extremely effective in treating ischemic heart conditions, its use must be closely monitored, which is best done by a healthcare professional. This ensures the safe and effective use of the medicine for the long term.