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 |
|
| Benefit of ADP receptor antagonists in atherothrombotic patients: new evidence. | 2001 |
|
| Atherothrombosis: a major health burden. | 2001 |
|
| Antithrombotic drugs for secondary stroke prophylaxis. | 2001 Apr |
|
| Management of neurological complications of carotid artery stenting. | 2001 Aug |
|
| Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. | 2001 Aug 16 |
|
| Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. | 2001 Aug 18 |
|
| Clopidogrel in invasive management of non-ST-elevation ACS. | 2001 Aug 18 |
|
| Bench to bedside: the development of rapamycin and its application to stent restenosis. | 2001 Aug 21 |
|
| Severe hypersensitivity associated with clopidogrel. | 2001 Aug 21 |
|
| Antithrombotic drugs for older subjects. Guidelines formulated jointly by the Italian Societies of Haemostasis and Thrombosis (SISET) and of Gerontology and Geriatrics (SIGG). | 2001 Feb |
|
| Thrombolysis and antithrombotic therapy for coronary artery disease. | 2001 Feb |
|
| Key role of the P2Y(1) receptor in tissue factor-induced thrombin-dependent acute thromboembolism: studies in P2Y(1)-knockout mice and mice treated with a P2Y(1) antagonist. | 2001 Feb 6 |
|
| Stasis ulcers refractory to therapy--accelerated healing by treatment with clopidogrel +/- dalteparin: a preliminary report. | 2001 Jan |
|
| Identification of the platelet ADP receptor targeted by antithrombotic drugs. | 2001 Jan 11 |
|
| Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery. | 2001 Jan 23 |
|
| Febrile pancytopenia associated with clopidogrel. | 2001 Jan 8 |
|
| Clopidogrel (Plavix): hematological reactions. | 2001 Jan 9 |
|
| Current perspectives on British use of adjunctive therapies during coronary interventions. | 2001 Jul |
|
| Extensive thrombus prior to elective percutaneous coronary intervention. | 2001 Jul |
|
| Randomized comparison of ticlopidine and clopidogrel after intracoronary stent implantation in a broad patient population. | 2001 Jul 31 |
|
| Acute coronary syndrome: are intervention and IIb/IIIa platelet inhibitors epiphenomena? | 2001 Jul-Aug |
|
| [New platelet inhibitors]. | 2001 Mar |
|
| [Cost effectiveness of clopidogrel in secondary cardiovascular prevention: a cost-effectiveness analysis based on the Caprie Study]. | 2001 Mar 29 |
|
| [Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery]. | 2001 May |
|
| P2y(12), a new platelet ADP receptor, target of clopidogrel. | 2001 May 4 |
|
| 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 |
|
| Thrombotic thrombocytopenic purpura associated with clopidogrel administration: case report and brief review. | 2001 Sep |
|
| Adjunctive therapies in the cath lab. Subacute stent thrombosis developing twelve days after discontinuation of ticlopidine treatment. | 2001 Sep |
|
| Endovascular brachytherapy for prophylaxis against restenosis after long-segment femoropopliteal placement of stents: initial results. | 2001 Sep |
|
| Complications of oral antiplatelet medications. | 2001 Sep |
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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| Classification Tree | Code System | Code | ||
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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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NDF-RT |
N0000008832
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NDF-RT |
N0000182142
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N0000175578
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LIVERTOX |
NBK547946
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EMA ASSESSMENT REPORTS |
CLOPIDOGREL ACINO (AUTHORIZED: MYOCARDIAL INFARCTION)
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CHEMBL1771
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C055162
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m3655
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113665-84-2
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CLOPIDOGREL
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758613
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N0000182143
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Clopidogrel
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37941
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32968
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C61686
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60606
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METABOLITE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
SALT/SOLVATE (PARENT)
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SUBSTANCE RECORD