Clopidogrel

Question 1

What conditions is clopidogrel used first line?

Answer 1

• PAD
• Ischaemic Stroke

Question 2

Clopidogrel is a thienopyridine. Give some examples of other thienopyridines:

Answer 2

• Prasugrel
• Ticagrelor
• Ticlopidine

Question 3

What is the MoA of clopidogrel?

Answer 3

It’s an antagonist of the P2Y12 adenosine diphosphate (ADP) receptor, inhibiting the activation of platelets

Question 4

A patient who is intolerant of aspirin is started on clopidogrel for the secondary prevention of ischaemic heart disease. Concurrent use of which one of the following drugs may make clopidogrel less effective?

• Warfarin
• Omeprazole
• Codeine
• Long-term tetracycline use (e.g. For acne rosacea)
• Selective serotonin reuptake inhibitors

Answer 4

Omeprazole

• MHRA concurrent use of clopidogrel with omeprazole or esomeprazole may make clopidogrel less effective - Don’t do it.
• Lansoprazole is fine though.