Hypersensitivity reactions to clopidogrel
- John R Cohn, MD
John R Cohn, MD
- Professor of Medicine and Pediatrics
- Thomas Jefferson University
- Michael P Savage, MD
Michael P Savage, MD
- Ralph J Roberts Professor of Cardiology
- Thomas Jefferson University
- Section Editors
- N Franklin Adkinson, Jr, MD
N Franklin Adkinson, Jr, MD
- Section Editor — Drug Allergy
- Professor of Medicine
- Johns Hopkins University School of Medicine
- Donald Cutlip, MD
Donald Cutlip, MD
- Section Editor — Interventional Cardiology
- Professor of Medicine
- Harvard Medical School
- Beth Israel Deaconess Medical Center
Clopidogrel is a thienopyridine drug that inhibits platelet aggregation by blocking the adenosine diphosphate P2Y12 receptor. The most frequent use of clopidogrel is to prevent potentially fatal thrombosis of newly implanted coronary stents. Accordingly, hypersensitivity reactions to clopidogrel have particular importance in this setting, since the timing typically coincides with the period of heightened vulnerability for stent thrombosis. The most common hypersensitivity reactions to clopidogrel are dermatologic eruptions, although severe systemic reactions can also occur.
The incidence and clinical manifestations of clopidogrel reactions are discussed here. Management options for dermatologic eruptions are also reviewed. Therapeutic use of clopidogrel in the management of atherosclerotic arterial disease is reviewed separately:
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- CLINICAL MANIFESTATIONS
- Most common signs and symptoms
- Other cutaneous reactions
- More serious types of systemic reactions
- RISK FACTORS
- Allergy testing
- Differential diagnosis
- Reactions that necessitate stopping clopidogrel
- Treating through
- - Advantages
- - Advantages
- - Types of clopidogrel reactions that have been managed with desensitization
- - Protocol
- - Success rate
- ALTERNATE THERAPIES
- Other P2Y12 inhibitors
- Cross-reactivity among drugs
- COMMON CLINICAL SCENARIOS
- Reactions soon after initiation
- Retreatment after a past reaction
- SUMMARY AND RECOMMENDATIONS