Cardiology · Pathway 65
Clopidogrel
Key points
- Thienopyridine P2Y12 ADP-receptor antagonist, inhibiting platelet activation (class: prasugrel, ticagrelor, ticlopidine).
- Uses: with aspirin in ACS (ticagrelor or prasugrel are often preferred in ACS). Clopidogrel is first-line for long-term secondary prevention after ischaemic stroke/TIA and in peripheral arterial disease. Short-term dual antiplatelet (aspirin + clopidogrel, about 21 days) is now used after minor ischaemic stroke or high-risk TIA.
- Interaction: PPIs may reduce clopidogrel efficacy (MHRA) — omeprazole and esomeprazole are of most concern; lansoprazole is considered acceptable.
Decision points in this pathway
- Patient on a PPI?
The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.