Pharma clinics. Le medicament du mois. Le clopidogrel (Plavix).

Clopidogrel is launched in Belgium by Sanofi-Synthelabo and Bristol-Myers Squibb under the trade name of Plavix. It is a potent and irreversible ADP receptor antagonist that proved to be more effective than aspirin as antiplatelet agent in the multicentre, randomised double-blind CAPRIE study. It is indicated, at a dosage of 75 mg/day, for the reduction of atherosclerotic events including myocardial infarction, ischaemic stroke and vascular death in patients with atherosclerosis manifested by recent stroke, myocardial infarction or established peripheral vascular disease. Furthermore, recent studies demonstrated that the combination of clopidogrel with aspirin is more effective than aspirin alone and better tolerated than the combination ticlopidine-aspirin for the prevention of atherothrombosis after placement of intravascular stents. Ongoing trials are evaluating the efficacy and safety of such clopidogrel-aspirin combination after acute ischaemic coronary events or in patients at very high risk of stroke. Thus the indications of clopidogrel may become even larger in a next future.