Acetylsalicylic acid, Clopidogrel
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Clopidogrel is a prodrug, one of the active metabolites of which is an inhibitor of platelet aggregation. The active metabolite of clopidogrel selectively inhibits the binding of adenosine diphosphate (ADP) to the P2Y12 platelet receptor and subsequent ADP-mediated activation of the GPIIb / IIIa complex, leading to suppression of platelet aggregation. Due to irreversible binding, platelets remain immune to ADP stimulation for the rest of their life (approximately 7-10 days), and the restoration of normal platelet function occurs at a rate corresponding to the rate of platelet renewal. Platelet aggregation induced by agonists other than ADP is also inhibited by blocking the increased platelet activation by released ADP. Since the formation of an active metabolite occurs with the help of isoenzymes of the P450 system, some of which may differ in polymorphism or may be inhibited by other drugs, not all patients may have adequate inhibition of platelet aggregation. With a daily intake of clopidogrel at a dose of 75 mg, from the very first day of administration, there is a significant suppression of ADP-induced platelet aggregation, which gradually increases over 3-7 days and then reaches a constant level (upon reaching an equilibrium state). In an equilibrium state, platelet aggregation is suppressed by an average of 40-60%. After discontinuing clopidogrel, platelet aggregation and bleeding time gradually return to baseline, on average, within 5 days ... Clopidogrel is able to prevent the development of atherothrombosis in any localization of atherosclerotic vascular lesions, in particular, with lesions of the cerebral, coronary or peripheral arteries. The ACTIVE-A clinical trial showed that in patients with atrial fibrillation who had at least one risk factor for vascular complications, but were unable to take indirect anticoagulants, clopidogrel in combination with acetylsalicylic acid (compared with taking only acetylsalicylic acid) reduced the incidence of combined stroke, myocardial infarction, systemic thromboembolism outside the central nervous system (CNS), or vascular death, largely by reducing the risk of stroke. The effectiveness of taking clopidogrel in combination with acetylsalicylic acid was detected early and lasted up to 5 years. The decrease in the risk of major vascular complications in the group of patients taking clopidogrel in combination with acetylsalicylic acid was mainly due to a greater decrease in the incidence of strokes. The risk of developing a stroke of any severity when taking clopidogrel in combination with acetylsalicylic acid decreased, and there was also a tendency to a decrease in the incidence of myocardial infarction in the group treated with clopidogrel in combination with acetylsalicylic acid, but there were no differences in the incidence of non-CNS thromboembolism or vascular death. In addition, taking clopidogrel in combination with acetylsalicylic acid reduced the total number of days of hospitalization for cardiovascular reasons.
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- Brand name: Plagryl
- Active ingredient: Acetylsalicylic acid, Clopidogrel
- Manufacturer: Dr. Reddy`s
- Country of Origin: India
Studies and clinical trials of Acetylsalicylic acid, Clopidogrel (Click to expand)
- Predictors and time trends in clopidogrel and proton pump inhibitor coprescription with low-dose acetylsalicylic acid
- Review of an article: Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. Jill J.F. Belch, MD, FRCP, John Dormandy, MD, FRCS, and the CASPAR Writing Committee, Dundee and London, United Kingdom (J Vasc Surg 2010;52:825-33)
- Dual low response to acetylsalicylic acid and clopidogrel is associated with myonecrosis and stent thrombosis after coronary stent implantation
- Regarding “Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial”
- Superior efficacy of clopidogrel plus acetylsalicylic acid compared with extended-release dipyridamole plus acetylsalicylic acid in preventing arterial thrombogenesis in healthy volunteers
- The platelet inhibiting effect of a clopidogrel bolus dose in patients on long-term acetylsalicylic acid treatment
- Catheter thrombosis during primary percutaneous coronary intervention for acute ST elevation myocardial infarction despite subcutaneous low-molecular-weight heparin, acetylsalicylic acid, clopidogrel and abciximab pretreatment
- PCV76 COST-EFFECTIVENESS ANALYSIS OF THE USE OF ACETYLSALICYLIC ACID COMPARED TO CLOPIDOGREL IN THE SECONDARY PREVENTION OF PATIENTS WITH PREVIOUS MYOCARDIAL INFRACTION
- Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial
- The impact of CYP3A5*1/*3, PIA1/A2 and T744C polymorphisms on clopidogrel and acetylsalicylic acid response variability in Mexican population
- Bilateral Hemothorax Secondary to Combined Antiplatelet Therapy With Clopidogrel and Acetylsalicylic Acid
- Effects of rivaroxaban, acetylsalicylic acid and clopidogrel as monotherapy and in combination in a porcine model of stent thrombosis
- Effect of chronic treatment with acetylsalicylic acid and clopidogrel on atheroprogression and atherothrombosis in ApoE-deficient mice in vivo
- Low prevalence of clopidogrel and acetylsalicylic acid resistance in patients with acute myocardial infarction and pantoprazole treatment in everyday practice
- The Pharmacokinetics and Safety of a Fixed-Dose Combination of Acetylsalicylic Acid and Clopidogrel Compared With the Concurrent Administration of Acetylsalicylic Acid and Clopidogrel in Healthy Subjects: A Randomized, Open-Label, 2-Sequence, 2-Period, Single-Dose Crossover Study
- Effects of ex vivo platelet supplementation on platelet aggregability in blood samples from patients treated with acetylsalicylic acid, clopidogrel, or ticagrelor
- Pharmacoeconomic Evaluation Acceptability of Clopidogrel Versus Acetylsalicylic Acid in Patients with Cardiovascular Disease for Stroke Prevention in Ukraine
- We-P11:236 Acetylsalicylic acid and clopidogrel resistance: Possible role of risk factors, medication and hemorheological variables
- W1004 Time Trends in the Prescription of Low-Dose Acetylsalicylic Acid, Clopidogrel and Proton Pump Inhibitors in UK Primary Care
- RISK OF UPPER GASTROINTESTINAL BLEEDING AMONG USERS OF CLOPIDOGREL AND LOW-DOSE ACETYLSALICYLIC ACID
- Uneventful Removal of an Epidural Catheter Guided by Impedance Aggregometry in a Patient With Recent Coronary Stenting and Treated With Clopidogrel and Acetylsalicylic Acid
- Effect of Esomeprazole With/Without Acetylsalicylic Acid, Omeprazole and Lansoprazole on Pharmacokinetics and Pharmacodynamics of Clopidogrel in Healthy Volunteers