Clopidogrel Interactions: Consider while prescribing

Abstract

Clopidogrel reduces the cardiovascular risks because of inhibitory action on platelets aggregation but some co-administered drugs compromise its main therapeutic effects. Clopidogrel is a prodrug and converted into active metabolite by the hepatic cytochrome P450. The active thiol metabolite inhibits the P2Y12 adenosine di-phosphate receptors and decrease the platelet aggregation processes. The activity of clopidogrel is dependent on the metabolic conversion by cytochrome P450 due to this fact proton pump inhibitors, atorvastatin and several other drugs that competitively inhibit the clopidogrel metabolism might alter its therapeutic response.

Conversely other agents potentiate the clopidogrel responsiveness by inducing the cytochrome activity. Combinational drug therapy increases the risks of drug-drug interactions. The previous pharmacodynamic studies have reported clinically significant risks that are associated with combined therapy of clopidogrel with other drugs which are commonly used in coronary artery disorders. These reported studies did not demonstrate the consistent evidence for sever drug-drug interaction hazards in cardiovascular events.

This review highlights the various controversies among the studies about common clopidogrel interactions when prescribed in various cardiovascular disorders to achieve targeted therapeutic outcomes. The clopidogrel is commonly prescribed in many serious disorders such as cardiovascular, hypercholesteraemia and lack of information or uncertainty may cost serious outcomes.

Keywords: Clopidogrel, Interactions, Cardiovascular, Proton pump inhibitors