Clopistad Drug Interactions

Since clopidogrel is metabolised to its active metabolite by CYP2C19, use of drugs that inhibit the activity of this enzyme would be expected to result in reduced drug levels of the active metabolite of clopidogrel and a reduction in clinical efficacy. Concomitant use of drugs that inhibit CYP2C19 (e.g. proton pump inhibitors) should be discouraged.
Aspirin: There is an increased risk of bleeding if clopidogrel is given with aspirin, but the use of low-dose aspirin and clopidogrel can be beneficial.
Heparin: No alteration of heparin dosage or coagulation effect and no effect on clopidogrel-induced inhibition of platelet aggregation with concomitant therapy. A pharmacodynamic interaction between clopidogrel and heparin is possible, leading to increased risk of bleeding. Therefore, concomitant use should be undertaken with caution.
Thrombolytics: The safety of the concomitant administration of clopidogrel, fibrin or non-fibrin specific thrombolytic agents and heparins was assessed in patients with acute myocardial infarction. The incidence of clinically significant bleeding was similar to that observed when thrombolytic agents and heparin are co-administered with ASA.
Other nonsteroidal anti-inflammatory agents: Clopidogrel warn about possible gastrointestinal bleeding if it is used with naproxen or other nonsteroidal anti-inflammatory drugs.
Warfarin: Potential pharmacodynamic interaction (increased risk of bleeding).