Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C16H16ClNO2S |
Molecular Weight | 321.822 |
Optical Activity | ( + ) |
Defined Stereocenters | 1 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
COC(=O)[C@@H](N1CCC2=C(C1)C=CS2)C3=CC=CC=C3Cl
InChI
InChIKey=GKTWGGQPFAXNFI-HNNXBMFYSA-N
InChI=1S/C16H16ClNO2S/c1-20-16(19)15(12-4-2-3-5-13(12)17)18-8-6-14-11(10-18)7-9-21-14/h2-5,7,9,15H,6,8,10H2,1H3/t15-/m0/s1
Clopidogrel, an antiplatelet agent structurally and pharmacologically similar to ticlopidine, is used to inhibit blood clots in a variety of conditions such as peripheral vascular disease, coronary artery disease, and cerebrovascular disease. Clopidogrel is sold under the name Plavix by Sanofi and Bristol-Myers Squibb. Plavix (clopidogrel bisulfate) is an inhibitor of ADP-induced platelet aggregation acting by direct
inhibition of adenosine diphosphate (ADP) binding to its receptor and of the subsequent ADPmediated
activation of the glycoprotein GPIIb/IIIa complex. Clopidogrel must be metabolized by CYP450 enzymes to produce the active metabolite that
inhibits platelet aggregation. The active metabolite of clopidogrel selectively inhibits the
binding of adenosine diphosphate (ADP) to its platelet P2Y12 receptor and the subsequent ADPmediated
activation of the glycoprotein GPIIb/IIIa complex, thereby inhibiting platelet
aggregation. This action is irreversible. Consequently, platelets exposed to clopidogrel’s active
metabolite are affected for the remainder of their lifespan (about 7 to 10 days). Platelet
aggregation induced by agonists other than ADP is also inhibited by blocking the amplification
of platelet activation by released ADP. Plavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events.
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
6.9 null [pKi] | |||
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | PLAVIX Approved UsePlavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as
follows:
• Recent MI, Recent Stroke or Established Peripheral Arterial Disease
For patients with a history of recent myocardial infarction (MI), recent stroke, or established
peripheral arterial disease, Plavix has been shown to reduce the rate of a combined endpoint
of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.
• Acute Coronary Syndrome
-For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/nonQ-wave
MI) including patients who are to be managed medically and those who are to be
managed with percutaneous coronary intervention (with or without stent) or CABG, Plavix
has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI, or
stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or
refractory ischemia.
Plavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as
follows:
• Recent MI, Recent Stroke or Established Peripheral Arterial Disease
For patients with a history of recent myocardial infarction (MI), recent stroke, or established
peripheral arterial disease, Plavix has been shown to reduce the rate of a combined endpoint
of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.
• Acute Coronary Syndrome
-For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/nonQ-wave
MI) including patients who are to be managed medically and those who are to be
managed with percutaneous coronary intervention (with or without stent) or CABG, Plavix
has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI, or
stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or
refractory ischemia. Launch Date1997 |
|||
Primary | PLAVIX Approved UsePlavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as
follows:
• Recent MI, Recent Stroke or Established Peripheral Arterial Disease
For patients with a history of recent myocardial infarction (MI), recent stroke, or established
peripheral arterial disease, Plavix has been shown to reduce the rate of a combined endpoint
of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.
• Acute Coronary Syndrome
-For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/nonQ-wave
MI) including patients who are to be managed medically and those who are to be
managed with percutaneous coronary intervention (with or without stent) or CABG, Plavix
has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI, or
stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or
refractory ischemia. Launch Date1997 |
|||
Primary | PLAVIX Approved UsePlavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as
follows:
• Recent MI, Recent Stroke or Established Peripheral Arterial Disease
For patients with a history of recent myocardial infarction (MI), recent stroke, or established
peripheral arterial disease, Plavix has been shown to reduce the rate of a combined endpoint
of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.
• Acute Coronary Syndrome
-For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/nonQ-wave
MI) including patients who are to be managed medically and those who are to be
managed with percutaneous coronary intervention (with or without stent) or CABG, Plavix
has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI, or
stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or
refractory ischemia. Launch Date1997 |
|||
Preventing | PLAVIX Approved UsePlavix (clopidogrel bisulfate) is indicated for the reduction of atherothrombotic events as
follows:
• Recent MI, Recent Stroke or Established Peripheral Arterial Disease
For patients with a history of recent myocardial infarction (MI), recent stroke, or established
peripheral arterial disease, Plavix has been shown to reduce the rate of a combined endpoint
of new ischemic stroke (fatal or not), new MI (fatal or not), and other vascular death.
• Acute Coronary Syndrome
-For patients with non-ST-segment elevation acute coronary syndrome (unstable angina/nonQ-wave
MI) including patients who are to be managed medically and those who are to be
managed with percutaneous coronary intervention (with or without stent) or CABG, Plavix
has been shown to decrease the rate of a combined endpoint of cardiovascular death, MI, or
stroke as well as the rate of a combined endpoint of cardiovascular death, MI, stroke, or
refractory ischemia. Launch Date1997 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
0.521 ng/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02185534 |
75 mg single, oral dose: 75 mg route of administration: oral experiment type: single co-administered: |
CLOPIDOGREL plasma | Homo sapiens population: healthy age: sex: food status: |
|
15800 pg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
4600 pg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
2520 pg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
1500 pg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
1.09 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02185534 |
75 mg single, oral dose: 75 mg route of administration: oral experiment type: single co-administered: |
CLOPIDOGREL plasma | Homo sapiens population: healthy age: sex: food status: |
|
0.767 ng*h/mL Clinical Trial https://clinicaltrials.gov/ct2/show/NCT02185534 |
75 mg single, oral dose: 75 mg route of administration: oral experiment type: single co-administered: |
CLOPIDOGREL plasma | Homo sapiens population: healthy age: sex: food status: |
|
50600 pg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
9890 pg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
7440 pg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
3130 pg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
5.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
7.9 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
300 mg single, oral dose: 300 mg route of administration: Oral experiment type: SINGLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
7.4 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FED |
|
8.5 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22128201 |
75 mg 1 times / day multiple, oral dose: 75 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
2% |
unknown, unknown |
CLOPIDOGREL BISULFATE plasma | Homo sapiens population: UNKNOWN age: UNKNOWN sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
600 mg 1 times / day multiple, oral Highest studied dose Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
healthy, 20-45 years |
Other AEs: Uric acid abnormal... |
1650 mg single, oral Overdose |
unknown, 49 years |
|
600 mg 1 times / day multiple, oral Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
unhealthy, 59 years |
Disc. AE: Transaminases increased, Fever... AEs leading to discontinuation/dose reduction: Transaminases increased (1 patient) Sources: Fever (1 patient) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Uric acid abnormal | 5 patients | 600 mg 1 times / day multiple, oral Highest studied dose Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
healthy, 20-45 years |
Fever | 1 patient Disc. AE |
600 mg 1 times / day multiple, oral Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
unhealthy, 59 years |
Transaminases increased | 1 patient Disc. AE |
600 mg 1 times / day multiple, oral Dose: 600 mg, 1 times / day Route: oral Route: multiple Dose: 600 mg, 1 times / day Sources: |
unhealthy, 59 years |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 169.0 |
no | |||
Page: 91, 169 |
no | |||
no | ||||
Page: 91, 169 |
no | |||
Page: 169.0 |
no | |||
Page: 91, 169 |
no | |||
Page: 169.0 |
no | |||
Page: 91, 169 |
no | |||
Page: 169.0 |
no | |||
Page: 91, 169 |
no | |||
Page: 169.0 |
no | |||
Page: 91, 169 |
no | |||
Page: 74.0 |
no | |||
weak | ||||
weak | ||||
yes [IC50 0.307 uM] | ||||
yes [IC50 6.25 uM] | ||||
Page: 91, 170 |
yes [Ki 28 uM] | |||
yes | ||||
Page: 22.0 |
yes | |||
yes | ||||
Page: 74.0 |
yes | |||
Page: 74.0 |
yes |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 168.0 |
likely | |||
Page: 168.0 |
likely | |||
Page: 168.0 |
likely | |||
Page: 168.0 |
no | |||
Page: 168.0 |
no | |||
no | ||||
no | ||||
no | ||||
no | ||||
yes [Km 181 uM] | ||||
yes [Km 19 uM] | ||||
yes [Km 20.9 uM] | ||||
yes [Km 5.61 uM] | ||||
yes | ||||
Page: 168.0 |
yes | |||
Page: 168.0 |
yes | |||
Page: 168.0 |
yes | |||
yes | ||||
Page: 74.0 |
yes |
PubMed
Title | Date | PubMed |
---|---|---|
Management practices in carotid stenting. | 2001 |
|
The use of antiplatelet agents in acute cardiac care. | 2001 Apr |
|
Clinical application of procedural platelet monitoring during percutaneous coronary intervention among patients at increased bleeding risk. | 2001 Apr |
|
Aspirin in patients with coronary artery disease: is it simply irresistible? | 2001 Apr |
|
Clinical and angiographical follow-up after implantation of a 6--12 microCi radioactive stent in patients with coronary artery disease. | 2001 Apr |
|
Ultrasound guided percutaneous thrombin injection of iatrogenic femoral artery pseudoaneurysms after coronary angiography and intervention. | 2001 Apr |
|
Radiation-induced glomerular thrombus formation and nephropathy are not prevented by the ADP receptor antagonist clopidogrel. | 2001 Aug 1 |
|
Newer antiplatelet therapies in stroke prevention. | 2001 Feb |
|
Antithrombotic and thrombolytic therapy for ischemic stroke. | 2001 Feb |
|
[Update on the treatment with platelet antiaggregation agents]. | 2001 Jan |
|
Effect of a high loading dose of clopidogrel on platelet function in patients undergoing coronary stent placement. | 2001 Jan |
|
Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery. | 2001 Jan 23 |
|
Multiple intracranial aneurysms as delayed complications of an atrial myxoma: case report. | 2001 Jul |
|
Comparison of two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab, for the prevention of ischemic events with percutaneous coronary revascularization. | 2001 Jun 21 |
|
Activation of Gi-coupled receptors releases a tonic state of inhibited platelet aggregation. | 2001 Mar |
|
Initial experience with a newer generation coronary stent. | 2001 Mar |
|
What is the optimal medical management of ischemic heart failure? | 2001 Mar-Apr |
|
[Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery]. | 2001 May |
|
Orbofiban: an orally active GPIIb/IIIa platelet receptor antagonist. | 2001 May |
|
Clopidogrel and aplastic anaemia. | 2001 May 5 |
|
Methods and models to evaluate shear-dependent and surface reactivity-dependent antithrombotic efficacy. | 2001 Nov 1 |
|
Antiplatelet agents for secondary prevention of ischemic stroke. | 2001 Oct |
|
Prevention of venous graft sclerosis with clopidogrel and aspirin combined with a mesh tubing in a dog model of arteriovenous bypass grafting. | 2001 Oct |
|
Effects of clopidogrel pretreatment before percutaneous coronary intervention in patients treated with glycoprotein IIb/IIIa inhibitors (abciximab or tirofiban). | 2001 Oct 15 |
|
Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. | 2001 Sep |
|
Effects of combining three different antiplatelet agents on platelets and leukocytes in whole blood in vitro. | 2001 Sep |
|
Recovery of platelet function after discontinuation of clopidogrel treatment in healthy volunteers. | 2001 Sep |
|
Complications of oral antiplatelet medications. | 2001 Sep |
|
Clopidogrel versus aspirin after cardiac surgery. | 2001 Sep 25 |
Sample Use Guides
Recent MI, Recent Stroke, or Established Peripheral Arterial Disease
The recommended daily dose of is 75 mg once daily.
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/10077233
Incubation of human washed platelets with clopidogrel resulted in a time- (maximum effects after 30 min) and concentration-dependent (IC50 1.9+/-0.3 uM) inhibition of ADP (6 uM)-induced platelet aggregation. Clopidogrel (30 uM) did not inhibit collagen (2.5 ug ml(-1))-, U46619 (1 uM)- or thrombin (0.1 u ml(-1))-induced platelet aggregation.
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NDF-RT |
N0000008832
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WHO-VATC |
QB01AC04
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WHO-ATC |
B01AC04
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NCI_THESAURUS |
C80483
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EMA ASSESSMENT REPORTS |
CLOPIDOGREL ACINO (AUTHORIZED:ACUTE CORONARY SYNDROME)
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N0000008832
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N0000182142
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N0000175578
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NBK547946
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CLOPIDOGREL ACINO (AUTHORIZED: MYOCARDIAL INFARCTION)
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m3655
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113665-84-2
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N0000182143
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METABOLITE (PARENT)
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SUBSTANCE RECORD