Clopidogrel
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Clopidogrel is a thienopyridine P2Y12 receptor inhibitor widely used for secondary prevention after acute coronary syndromes and percutaneous coronary intervention (PCI). The CURE and COMMIT trials established dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel as standard of care. It is a prodrug requiring hepatic CYP2C19 activation.
Exploratory record, not a reviewed medical publication.
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This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Clopidogrel is a thienopyridine P2Y12 receptor inhibitor widely used for secondary prevention after acute coronary syndromes and percutaneous coronary intervention (PCI). NutriStack rates the supporting evidence as strong. Common adult dosing is 75 mg once daily (with 300–600 mg loading dose for ACS/PCI) (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 12 sources.
The bottom line
Evidence rating strong. Most-documented uses: reduces cardiovascular events in acs (cure trial), essential component of dapt after coronary stenting, alternative to aspirin in aspirin-allergic patients. 12 sources indexed (2002–2026), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Thienopyridine prodrug that requires two-step hepatic metabolism via CYP2C19 (primarily) to generate the active metabolite. The active metabolite irreversibly binds to the platelet P2Y12 ADP receptor, blocking ADP-mediated platelet activation and aggregation for the platelet's lifespan (~7–10 days). CYP2C19 poor metabolizers have reduced drug efficacy.
Dosing & protocol.
Can be taken with or without food; requires CYP2C19 hepatic activation, poor metabolizers may have reduced efficacy
Full safety detail.
Side effects
- Bleeding
- Bruising
- Diarrhea
- Rash and pruritus
- GI discomfort
- Thrombotic thrombocytopenic purpura (TTP, rare)
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
7- 1Ticagrelor Versus Clopidogrel or Aspirin in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled TrialsPMIDZaihan AF, Mohamad Hafiz NAH, Tong YS et al. · Stroke research and treatment · 2026
Zaihan AF, Mohamad Hafiz NAH, Tong YS et al.. Ticagrelor Versus Clopidogrel or Aspirin in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Stroke research and treatment. 2026
- 2Ticagrelor or Clopidogrel Monotherapy vs Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: A Systematic Review and Patient-Level Meta-AnalysisPMIDValgimigli M, Gragnano F, Branca M, Franzone A et al. · JAMA Cardiology · 2024
Clopidogrel or ticagrelor monotherapy after a short DAPT period was associated with lower bleeding risk compared with prolonged DAPT, without increasing ischemic risk after PCI
- 3A comparison of the effects of ticagrelor and clopidogrel in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trialsPMIDGeravandi M, Nourabi M, Navabifar S et al. · BMC pharmacology & toxicology · 2024
Geravandi M, Nourabi M, Navabifar S et al.. A comparison of the effects of ticagrelor and clopidogrel in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials. BMC pharmacology & toxicology. 2024
- 4Ticagrelor Versus Clopidogrel in Endovascular Therapy for Cerebral Aneurysms: A Systematic Review and Meta-AnalysisPMIDAl-Salihi MM, Saha R, Gillani SA et al. · World neurosurgery · 2024
Al-Salihi MM, Saha R, Gillani SA et al.. Ticagrelor Versus Clopidogrel in Endovascular Therapy for Cerebral Aneurysms: A Systematic Review and Meta-Analysis. World neurosurgery. 2024
- 5Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysisPMIDLun R, Dhaliwal S, Zitikyte G, Roy DC et al. · JAMA Neurology · 2022
Ticagrelor-aspirin combination showed comparable efficacy to clopidogrel-aspirin for reducing recurrent stroke risk in patients with minor ischemic stroke or TIA, with clopidogrel-aspirin remaining a standard of care
- 6The potential interaction between clopidogrel and proton pump inhibitors: a systematic reviewPMIDLima JP, Brophy JM · BMC medicine · 2010
Lima JP, Brophy JM. The potential interaction between clopidogrel and proton pump inhibitors: a systematic review. BMC medicine. 2010
- 7Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stentingPMIDBhatt DL, Bertrand ME, Berger PB et al. · Journal of the American College of Cardiology · 2002
Bhatt DL, Bertrand ME, Berger PB et al.. Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stenting. Journal of the American College of Cardiology. 2002
Reference material
5- 8Yusuf S et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes (CURE). N Engl J Med. 2001.Source linkedPMID
- 9CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet. 1996.Source linkedPMID
- 10Ibrahim A et al. Efficacy and safety of clopidogrel versus aspirin monotherapy for secondary prevention after percutaneous coronary intervention: a GRADE-assessed meta-analysis with trial sequential analysis. J Cardiovasc Med (Hagerstown). 2026.Source linkedPMID
- 11Axelsson MAB, Parodi López N, Wikström Jonsson E et al.. Efficacy and Safety of Clopidogrel With and Without a Proton Pump Inhibitor: A Systematic Review and Meta-Analysis. Basic & clinical pharmacology & toxicology. 2025Source linkedPMID
- 12Valgimigli M, Choi KH, Giacoppo D et al.. Clopidogrel versus aspirin for secondary prevention of coronary artery disease: a systematic review and individual patient data meta-analysis. Lancet (London, England). 2025Source linkedPMID
Common questions.
Quick answers about Clopidogrel, drawn from the data on this page.
What is Clopidogrel?
Clopidogrel is a thienopyridine P2Y12 receptor inhibitor widely used for secondary prevention after acute coronary syndromes and percutaneous coronary intervention (PCI). The CURE and COMMIT trials established dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel as standard of care. It is a prodrug requiring hepatic CYP2C19 activation.
What is Clopidogrel used for?
Commonly cited benefits of Clopidogrel include: Reduces cardiovascular events in ACS (CURE trial); Essential component of DAPT after coronary stenting; Alternative to aspirin in aspirin-allergic patients; Reduces recurrent stroke (CAPRIE trial). NutriStack rates the overall evidence as strong.
What is a typical dose of Clopidogrel?
A typical adult dose of Clopidogrel is 75 mg once daily (with 300–600 mg loading dose for ACS/PCI) (as prescribed by your physician). The commonly recommended form is Oral tablet. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Clopidogrel?
Reported side effects include bleeding, bruising, diarrhea, rash and pruritus, gi discomfort, thrombotic thrombocytopenic purpura (ttp, rare). This is educational information; check with a healthcare professional before use.
How strong is the evidence for Clopidogrel?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Clopidogrel in NutriStack.
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