Clopidogrel
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ADIS DRUG EVALUATION
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Clopidogrel A Review of its Use in the Prevention of Thrombosis Greg L. Plosker and Katherine A. Lyseng-Williamson Wolters Kluwer Health | Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USA Various sections of the manuscript reviewed by: D.L. Bhatt, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA; C.L. Campbell, University of Kentucky, Lexington, Kentucky, USA; J. Carlsson, Department of Internal Medicine II, Klinikum Lippe-Detmold, Detmold, Germany; C. Doecke, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia; S. Dunn, University of Kentucky, Lexington, Kentucky, USA; J. Latour-P´erez, Hospital General Universitario de Elche and University de Alicante, Alicante, Spain; U. Zeymer, Herzzentrum Ludwigshafen, Ludwigshafen, Germany. Data Selection Sources: Medical literature published in any language since 1980 on clopidogrel, identified using MEDLINE and EMBASE, supplemented by AdisBase (a proprietary database of Adis International). Additional references were identified from the reference lists of published articles. Bibliographical information, including contributory unpublished data, was also requested from the company developing the drug. Search strategy: MEDLINE, EMBASE and AdisBase search term was ‘clopidogrel’. Searches were last updated 15 February 2007. Selection: Studies in patients with or at risk of cardiovascular disorders who received clopidogrel. Inclusion of studies was based mainly on the methods section of the trials. When available, large, well controlled trials with appropriate statistical methodology were preferred. Relevant pharmacodynamic and pharmacokinetic data are also included. Index terms: Clopidogrel, antiplatelet, acute coronary syndromes, atherothrombosis, percutaneous coronary intervention, myocardial infarction, stroke, pharmacodynamics, pharmacokinetics, therapeutic use.
Contents Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 614 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617 2. Pharmacodynamic Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617 3. Pharmacokinetic Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 618 3.1 Absorption and Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619 3.2 Metabolism and Elimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619 3.3 Special Populations . . . . .
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