clopidogrel

Mechanism of action

Inhibit platelet aggregation through binding to P2Y12 receptor on platelets.

Indication

Indicated for acute coronary syndrome in conjunction with aspirin.

Safety issues

Combinations of oral anticoagulants and platelet inhibitors increase bleeding risk and should be avoided in AF patients without another indication for platelet inhibition.

P2Y12 antagonists are contraindicated in severe active bleeding or conditions with an increased risk of severe active bleeding.

Avoid (or monitor closely) combination with other medicines that can affect blood clotting and increase the risk of bleeding.

Prasugrel and ticagrelor are used in acute coronary syndrome (with aspirin). They are more effective than clopidogrel but cause more bleeding.

• This is a high risk class of medicine*

Comments

P2Y12 inhibitors (clopidogrel, prasugrel or ticagrelor) are not recommended for the prevention of thromboembolic events or stroke in people with AF.

Oral anticoagulation with warfarin or a NOAC reduces thromboembolic complications and cardiovascular events more effectively than aspirin combined with a P2Y12 inhibitor.