Clopidogrel

Category: pharmacological

Aliases: Plavix

Pharmacological Mechanism

Thienopyridine antiplatelet prodrug — CYP2C19-mediated activation to thiol metabolite that irreversibly blocks platelet P2Y12 ADP receptor. CYP2C19 poor metabolizers + PPI co-administration reduce activation, lowering antiplatelet effect (clinically meaningful with omeprazole/esomeprazole; less with pantoprazole).

Half-Life (t½)

PO: 6h

Dosing Guidelines

• PO: Typical 75 mg (Range: 75–75 mg)

Target Organ Systems

• digestive
• immune-hematologic

Pathways It Modulates

• Adenosine receptor signaling (inhibitor) — P2Y12 receptor (related purinergic; not adenosine)
• Atherosclerosis plaque pathology (inhibitor) — P2Y12 (antiplatelet)
• Platelet aggregation (inhibitor) — P2Y12 — irreversible; CYP2C19 activation required
• Purinergic signaling (inhibitor) — P2Y12 irreversible (CYP2C19 prodrug — *2/*3 poor metabolizers have reduced effect)

Chemical Identifiers

• PubChem CID: 60606
• Formula: C16H16ClNO2S
• Molecular weight: 321.82 g/mol
• InChIKey: GKTWGGQPFAXNFI-HNNXBMFYSA-N
• SMILES: COC(=O)[C@H](C1=CC=CC=C1Cl)N2CCC3=C(C2)C=CS3

References

• PMID 10440419