Clopidogrel

Clopidogrel: Uses, Dosage and Side Effects

Overview

Clopidogrel irreversibly binds to the ADP(2Y12) receptor on platelets, preventing both primary and secondary platelet aggregation in response to stimuli.

Uses of Clopidogrel

• Thromboprophylaxis in cats and dogs.
• Commonly used to reduce the risk of thrombus formation in cats with advanced cardiac disease, to reduce the risk of thromboembolism in cats with a pre-existing thrombus, or recurrence of embolism in cats with a previous arterial thromboembolic event.

Dose of Clopidogrel in Dogs and Cats

Dogs:

• 1.1–4 mg/kg p.o. q24h.
• A single loading dose of 4–10 mg/kg p.o. may help achieve therapeutic concentrations more rapidly.

Cats:

• 18.75 mg/cat p.o. q24h.
• A single loading dose of 4–10 mg/kg p.o. may help achieve therapeutic concentrations more rapidly

Side Effects of Clopidogrel in Dogs and Cats

• Use with care in patients with renal or hepatic impairment.
• Tablet formulations for humans are film-coated, which needs to be broken for appropriate dosing in cats.
• Many cats dislike the taste of the tablets when the film-coating is broken so it is recommended that the tablet be administered in a gelatin capsule to improve patient compliance.
• The taste of newer resized formulations is anecdotally still not tolerated.
• Overdoses will be expected to lead to bleeding disorders

Contraindications of Clopidogrel in Dogs and Cats

• Bleeding disorders.
• GI ulceration.

Some Notes:

• May be substituted for aspirin if aspirin is not tolerated.
• May be used in conjunction with aspirin (as the drugs act on different parts of the platelet activation cycle).
• Recent evidence (FATCAT study) suggests clopidogrel is superior compared with aspirin in the delay of feline recurrent thromboembolic events secondary to cardiac disease.
• High risk of bleeding complications if used with anticoagulants.