WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, Clopidogrel, sold under the trade name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. Management: Avoid coadministration of BCRP/ABCG2 inhibitors and alpelisib due to the potential for increased alpelisib concentrations and toxicities. Morphine (Systemic) may decrease the serum concentration of Antiplatelet Agents (P2Y12 Inhibitors). This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.

It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent. Other acid-lowering therapies do not appear to share this interaction.PAZOPanib: BCRP/ABCG2 Inhibitors may increase the serum concentration of PAZOPanib. [DSC] = Discontinued productExtensively hepatic via esterase-mediated hydrolysis to a carboxylic acid derivative (inactive) and via CYP450-mediated (CYP2C19 primarily) oxidation to a thiol metabolite (active) Onset of action: Inhibition of platelet aggregation (IPA): Dose-dependent:300 to 600 mg loading dose: Detected within 2 hours50 to 100 mg/day: Detected by the second day of treatmentADP 5 micromole/L: 20% to 30% IPA at 6 hours post administration (Montelescot 2006)ADP 20 micromole/L: 30% to 37% IPA at 6 hours post administration (Montelescot 2006)50 to 100 mg/day: ADP 5 micromole/L: 50% to 60% IPA at 5 to 7 days (Herbert 1993)Platelet aggregation and bleeding time gradually return to baseline after ~5 days after discontinuation. Management: Use an initial ubrogepant dose of 50 mg and second dose (at least 2 hours later if needed) of 50 mg when used with a BCRP inhibitor.Urokinase: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Urokinase.
Management: Due to a risk for impaired clopidogrel effectiveness with such a combination, carefully consider the need for a strong CYP2C19 inhibitor in patients receiving clopidogrel. Crush four 75 mg tablets and reduce to a fine powder.
Tests are available to identify patients who are CYP2C19 poor metabolizers. Management: Carefully consider risks and benefits of this combination and monitor closely; Canadian labeling recommends avoiding prasugrel or ticagrelor.Dabrafenib: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Dabrafenib. Onset of effects is about two hours and lasts for five days. Erythromycin (Systemic): May diminish the antiplatelet effect of Clopidogrel.Esomeprazole: May diminish the antiplatelet effect of Clopidogrel. Desloratadine: CYP2C8 Inhibitors (Moderate) may increase the serum concentration of Desloratadine. If you have questions about side effects, call your doctor. Clopidogrel is a prodrug of a platelet inhibitor used to reduce the risk of myocardial …

Thrombolytic Agents: Agents with Antiplatelet Properties may enhance the anticoagulant effect of Thrombolytic Agents. Management: Decrease the dose of heparin or agents with antiplatelet properties if coadministration is required.Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry): May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Clopidogrel bisulfate (Plavix) is an anti-platelet drug, that is, a drug that inhibits the ability of platelets to clump together as part of a blood clot.Clopidogrel prevents blood clots by irreversibly binding to the P2Y12 receptor on platelets, preventing adenosine diphosphate (ADP) from activating platelets. Tipranavir: May enhance the antiplatelet effect of Agents with Antiplatelet Properties.Topotecan: BCRP/ABCG2 Inhibitors may increase the serum concentration of Topotecan. Ritonavir may decrease serum concentrations of the active metabolite(s) of Clopidogrel.Rivaroxaban: Antiplatelet Agents (P2Y12 Inhibitors) may enhance the adverse/toxic effect of Rivaroxaban. Specifically, clopidogrel may increase dabigatran serum concentrations. Parent drug: ~6 hours; Thiol derivative (active metabolite) ~30 minutes; carboxylic acid derivative (inactive; main circulating metabolite): ~8 hours; Parent drug: 98%; Inactive metabolite (carboxylic acid derivative): 94%After repeated doses of clopidogrel 75 mg/day, patients with severe (CrCl 5 to 15 mL/minute) and moderate (CrCl 30 to 60 mL/minute) renal impairment showed low (25%) inhibition of ADP-induced platelet aggregation.Less inhibition of ADP-induced platelet aggregation was observed in women.A randomized, controlled trial with blinded end point adjudication evaluated carotid artery stenting versus carotid endarterectomy in patients with carotid artery stenosis. (Moderate) Although aspirin may be used in combination with clopidogrel, both drugs are associated with bleeding. Specifically, the risk for bleeding may be increased. FentaNYL may decrease the serum concentration of Antiplatelet Agents (P2Y12 Inhibitors).Glucosamine: May enhance the antiplatelet effect of Agents with Antiplatelet Properties.Grapefruit Juice: May decrease serum concentrations of the active metabolite(s) of Clopidogrel.