Clopidogrel Oral- Composition, Usage and Side Effects

Introduction

Clopidogrel is a medication used alone or with aspirin to prevent the chance of heart attack or stroke. It belongs to the class of antiplatelet drugs. Platelets are small cell fragments in the blood that play an important role in the clotting process. When blood vessels are injured, platelets clump together to form a plug and stop bleeding.

The main function of antiplatelet drugs is to interfere with platelet activation and aggregation, which helps prevent the formation of abnormal or excessive blood clots within the blood vessels. By inhibiting platelet activity, these drugs reduce the risk of clotting complications, such as heart attacks and strokes.

Antiplatelet drugs like Clopidogrel prevent blood clots and reduce the risk of heart attacks and strokes in individuals with certain cardiovascular conditions. In this comprehensive article, we will learn about the composition, uses, recommended dosage, potential side effects, and address frequently asked questions about clopidogrel.

clopidogrel pack with tablets

Composition

The primary component of clopidogrel is clopidogrel bisulfate, which acts as an antiplatelet agent. These tablets are designed for oral administration and are available in various strengths, depending on the prescribed dosage.

Formula

The chemical formula of Clopidogrel bisulfate is C₁₆H₁₆ClNO₂S·H₂SO₄.

Clopidogrel is classified as a prodrug, which means that this drug, when orally administered, needs to be activated metabolically inside the body to exert its therapeutic effects. Once activated, clopidogrel inhibits platelet aggregation, preventing the formation of blood clots in the vessels, thus preventing stroke.

Uses

Clopidogrel is primarily prescribed for the following purposes:

  • Prevention of Atherosclerotic Events:
    • Atherosclerosis is a medical condition characterized by the buildup of fatty deposits called plaques within the arteries. The buildup of these plaques leads to narrowed blood vessels. Clopidogrel is commonly used to reduce the risk of atherosclerotic events such as heart attacks, strokes, and peripheral arterial disease. It is often prescribed to individuals who have recently had a heart attack or stroke, or those with established cardiovascular diseases.
  • Coronary Artery Stenting:
    • People with narrowed arteries undergo coronary artery stenting procedures to widen them.  After such procedures, there is a high risk of developing clots around the stents. Thus, such patients are typically prescribed clopidogrel to prevent the formation of blood clots around the stent. This reduces the risk of stent thrombosis and helps maintain optimal blood flow through the coronary arteries.

Why Use Clopidogrel?

Clopidogrel is used to prevent blood clots in individuals with various cardiovascular conditions. The symptoms of these conditions may include:

  • Chest pain or angina
    • Chest pain can occur as a result of reduced blood flow to the heart muscles. This means there is a high chance of myocardial infarction which can be fatal.
  • Shortness of breath
    • Impaired blood flow to the heart or body, in general, can lead to difficulty breathing because of decreased flow of oxygen to the tissues. This particularly happens during physical exertion or exercise.
  • Numbness or weakness in limbs
    • Reduced blood flow to the extremities may cause a tingling sensation or weakness.
  • Difficulty speaking or understanding speech:
    • This may indicate a transient ischemic attack (TIA) or stroke where a part of the brain gets devoid of blood, which results in permanent damage to that part. This caused difficulty speaking.
  • Sudden severe headache
    • Severe headaches can be a sign of a hemorrhagic stroke or other vascular issues. Reduced blood flow due to clot formation can result in decreased oxygen supply to the brain which can cause headaches.
  • Dizziness or loss of balance
    •  Impaired blood flow to the brain can result in dizziness and coordination problems because of decreased blood flow to the cerebellum.
  • Fatigue and weakness
    • Reduced blood supply to the tissues of the body can lead to persistent fatigue and weakness.

Recommended Dosage

The recommended dosage of clopidogrel may vary depending on the specific condition being treated and individual patient factors. It is important to follow the instructions provided by the healthcare professional and the guidelines on the medication label. Typically, the initial recommended dose is 75 mg per day, which can be taken with or without food.

For Oral Dosage Form

Clopidogrel is used for the prevention of heart attack or stroke in patients with the acute coronary syndrome (ACS). In such patients, the dosage of Clopidogrel varies with age.

For Adults:

  • At first, 300 milligrams (mg) is recommended as a single dose. Then, a maintenance dose of 75 mg once a day is recommended. Aspirin may also be given by the healthcare provider along with this medicine. 

For Children

  • The recommended dosage of Clopidogrel for children is determined by the doctors.

For patients who have had a heart attack, stroke or peripheral arterial disease previously, the recommended dosage is different.

For Adults

  • 75 milligrams (mg) once a day is recommended.

For Children

  • The recommended dosage for children with a history of previous heart attack or stroke is to be determined by the healthcare provider.

The duration of clopidogrel treatment may also vary. In most cases, it is prescribed for a minimum of one year following a heart attack or placement of a coronary artery stent. However, the duration may be extended based on the individual’s risk factors and the assessment of their healthcare provider.

It is important to note that clopidogrel should not be discontinued or the dosage altered without consulting a healthcare professional. Abruptly stopping the medication can increase the risk of blood clot formation and potentially lead to serious cardiovascular complications.

How To Use?

Clopidogrel is to be taken according to the advice of the doctor. You can take this medication with or without the food as it causes no side effects if taken with or without food. You are not supposed to take this medication if you are taking Omeprazole or Esomeprazole which are the antacids taken for treating indigestion and heartburn, and acid reflux.

Clopidogrel can not be taken with Alcohol as serious interactions may take place resulting in unwanted side effects.

Side Effects

While clopidogrel is generally well-tolerated, it can cause certain side effects in some individuals. Common side effects include:

  • Upset stomach or indigestion
    • Some individuals who use Clopidogrel regularly may experience gastrointestinal discomforts, such as nausea, vomiting, or abdominal pain.
  • Diarrhea
    • Clopidogrel can occasionally cause loose stools or diarrhea.
  • Headache
    • Mild headaches may occur, but they usually subside as the body adjusts to the medication.
  • Bruising or bleeding more easily
    • Clopidogrel’s antiplatelet effects can increase the risk of bruising or bleeding, even from minor injuries. This is because Clopidogrel is an antiplatelet drug and it inhibits the function of the platelets, cells that serve to stop the bleeding.
  • Nosebleeds
    • Some individuals may experience an increased tendency for nosebleeds. It is also because of its antiplatelet effect.
  • Rash or itching
    • Allergic reactions to clopidogrel can manifest as skin rashes or itching.

It is important to seek medical attention if any concerning or unusual symptoms develop while taking clopidogrel. In rare cases, more severe side effects may occur, such as severe allergic reactions, liver problems, or a decrease in blood cell count. Prompt medical evaluation and intervention are necessary in such situations.

Frequently Asked Questions (FAQs)

What is Clopidogrel used for?

Clopidogrel is an antiplatelet drug used in patients with increased risks of Heart attack or stroke. This medication prevents the sticking of platelets to the walls of vessels thus inhibiting the formation of blood clots. If you have an increased risk of clot formation in your vessels, Clopidogrel can help prevent clot formation.

Is Clopidogrel a blood thinner?

Clopidogrel is considered to be a blood thinner and can be given with aspirin which is also a blood thinner. It prevents heart attack and stroke in people with high risks of developing them.

Can I stop taking clopidogrel abruptly?

It is essential to consult your healthcare professional before stopping clopidogrel. Abruptly discontinuing the medication can increase the risk of blood clot formation and potentially lead to serious cardiovascular complications. Your doctor will determine the appropriate duration of treatment based on your individual circumstances.

Can I take other medications while on Clopidogrel?

It is crucial to inform your doctor about all the medications you are taking, including over-the-counter drugs and supplements. Some medications, such as certain anticoagulants or nonsteroidal anti-inflammatory drugs (NSAIDs), may interact with clopidogrel and increase the risk of bleeding. Your healthcare provider will review your medication regimen and provide guidance on potential drug interactions.

Is Clopidogrel safe during pregnancy?

Clopidogrel should only be used during pregnancy if the potential benefits outweigh the potential risks. It is important to discuss the risks and benefits with your healthcare provider if you are pregnant or planning to become pregnant. Your doctor will evaluate the necessity of continuing clopidogrel treatment and may explore alternative options that are safer during pregnancy.

Conclusion

In short, Clopidogrel is an antiplatelet medication that plays a role in preventing blood clots and reducing the risk of cardiovascular events. By inhibiting platelet aggregation, it helps maintain optimal blood flow and decreases the chances of heart attacks, strokes, and peripheral arterial disease. While generally well-tolerated, Clopidogrel can have side effects, and it is important to adhere to the recommended dosage and seek medical advice if any concerning symptoms arise.

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