Role of clopidogrel loading dose in patients with ST-segment elevation
The newer antiplatelets ticagrelor and prasugrel have demonstrated superiority over clopidogrel
All patients presenting with acute coronary syndromes should be given a 300 mg loading dose of clopidogrel, then 75 mg daily
Initiating Plavix without a loading dose will delay establishment of an antiplatelet effect by several days [see Clinical Pharmacology (12
A loading dose refers to a dose Introduction
Unstable angina, non-ST-segment elevation MI (NSTEMI): 300 mg loading dose; initiating therapy without a loading dose will delay establishment of antiplatelet effect by several days; following the loading dose, administer 75 mg/day PO for up to 12 months; may administer beyond 12 months if used in combination with aspirin
The authors note that "clopidogrel was the most common agent (91
Adult Loading dose 300 mg for 1 dose, to be taken prior to the procedure, alternatively loading dose 600 mg for 1 dose, to be taken prior to
This dose is expected to result in a steady-state effect on platelet aggregation after approximately 5–6 days
As a result, a 600 mg loading dose was associated with a significantly lower rate of major adverse cardiovascular events at 1 month and without any increase in bleeding complications
Clopidogrel should be added to ASA as soon as possible in patients with a non-invasive treatment strategy and continued for more than 1 month (class 1A) and up to 9 months (class 1B)
3) and Clinical Studies A 600 mg loading dose may lead to more rapid platelet inhibition
In patients with definite UA/NSTEMI undergoing PCI, the use of a loading dose of clopidogrel of 600mg, followed by a higher maintenance dose of 150mg daily for 6 days, then 75mg daily may be reasonable in patients not considered at high risk for bleeding
Objectives: We analyzed the benefit of a 600-mg clopidogrel loading dose on platelet reactivity and clinical outcomes after stenting for non-ST-segment elevation acute coronary syndrome (NSTE ACS)
The newer antiplatelets ticagrelor and prasugrel have demonstrated superiority over clopidogrel
8 The PCI guidelines recommend a 600-mg clopidogrel LD before or during the procedure