Caduet and Clopidogrel

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using atorvastatin and clopidogrel. This combination may reduce the effects of clopidogrel. Call your doctor promptly if you have any signs of blood clots such as chest pain, shortness of breath, sudden loss of vision, or pain, redness or swelling in an extremity. You may need a dose adjustment or special test if you take both medications. It is important that you tell your healthcare provider about all other medications that you are using including vitamins and herbs. Do not stop using your medications without talking to your doctor first.

MONITOR: The concomitant administration of atorvastatin may reduce the metabolic activation of the prodrug clopidogrel and its antiplatelet effects. The proposed mechanism is competitive inhibition of CYP450 3A4 enzymatic activity, which is responsible for the conversion of clopidogrel to its active metabolite. However, data have been conflicting. In a trial with coronary stent implant patients receiving clopidogrel 75 mg/day (n=44), the percent platelet aggregation was 34% with no atorvastatin, 58% with atorvastatin 10 mg, 74% with 20 mg, and 89% with 40 mg. Results from an in vitro study suggest that equimolar concentrations of atorvastatin inhibit clopidogrel metabolism by more than 90 %. However, in a post hoc analysis of a trial with percutaneous coronary intervention patients, no statistical differences in the incidence of bleeding, stroke, myocardial infarction, or death were found at 1 year with concomitant administration of clopidogrel 75 mg/day and CYP450 3A4-metabolized HMG-CoA reductase inhibitors (n=1001, atorvastatin, lovastatin, simvastatin, cerivastatin) or other statins (n=158, pravastatin, fluvastatin).

MANAGEMENT: Until more information is available, monitoring for altered efficacy of clopidogrel may be advisable if atorvastatin is coadministered with clopidogrel. Pravastatin, fluvastatin, and rosuvastatin are not metabolized by CYP450 3A4 and are theoretically not expected to interact with clopidogrel.

Caduet

Generic Name: amlodipine / atorvastatin

Brand name: Caduet

Synonyms: n.a.

What is Caduet?

Clopidogrel

Generic Name: clopidogrel

Brand name: Plavix

Synonyms: n.a.

What is Clopidogrel?