15 March 2010

New Clopidogrel (Plavix™) Warning

In the US, the FDA has added a warning to those patients taking clopidogrel, a widely-prescribed anti-blood clotting medication.

There is a subset of patients who are poor metabolizers of the drug. Because of this, these patients are not getting the full benefits of the medication. This particular group of patients have low CYP2C19 enzyme activity in their livers, which is necessary to convert clopidogrel into an active form which can prevent blood clotting.

In the US, there is a test available to detect if a patient has low or sufficient CYP2C19 enzyme activity. In the Philippines, however, I am not to sure. Even if it were available, I am certain it would be expensive.

The possible solution of dosage adjustment is met with the obstacle of identifying first this subset of patients who are poor metabolizers of clopidogrel. Also, an appropriate dose regimen for poor metabolizers has not been established yet in any clinical outcome trials.

The best option patients have is still to consult with their respective physicians. A possible shift to other anti-blood clotting medications maybe necessary.

More information can be found here.
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