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Clopidogrel, sold under the brand name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. [10] It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent (dual antiplatelet therapy). [10]
[55] [57] An interaction between PPIs and the metabolism of the platelet inhibitor clopidogrel is known and this drug is also often used in people with cardiac disease. [58] [59] [22] There are associations with an increased risk of stroke, but this appears to be more likely to occur in people who already have an elevated risk. [60]
Metabolism of ticlopidine, clopidogrel and prasugrel to an active metabolite. Clopidogrel is a prodrug that is metabolized by two pathways. In one of the pathway most of the dose of clopidogrel (85%) is hydrolyzed by esterases to an inactive carboxylic acid derivate and rapidly cleared via glucoridination followed by renal excretion.
An antiplatelet drug (antiaggregant), also known as a platelet agglutination inhibitor or platelet aggregation inhibitor, is a member of a class of pharmaceuticals that decrease platelet aggregation [1] and inhibit thrombus formation.
Clopidogrel, unlike prasugrel, was issued a black box warning from the FDA on 12 March 2010, as the estimated 2–14% of the US population who have low levels of the CYP2C19 liver enzyme needed to activate clopidogrel may not get the full effect. Tests are available to predict if a patient would be susceptible to this problem or not.
PPI exist in the forms of oral enteric coated tablets or enteric granules capped within capsules. To ensure the effectiveness of the medication, patients should swallow the whole tablet. [ 62 ] They should not chew or cut the tablets, nor open the capsule and grind the granules. [ 62 ]
Although still controversial, [41] this may increase the risk of stroke or heart attack in people taking clopidogrel to prevent these events. This interaction is possible because omeprazole is an inhibitor of the enzymes CYP2C19 and CYP3A4. [42] Clopidogrel is an inactive prodrug that partially depends on CYP2C19 for conversion to its active ...
capsule cap. capiat: let him take (let the patient take) c.m. cras mane: tomorrow morning c.m.s. cras mane sumendus: to be taken tomorrow morning c̄, c. cum: with (usually written with a bar on top of the c) cib. cibus: food c.c. cum cibo: with food [or] cubic centimetre