Clopidogrel with Etravirine Interaction Details
Brand Names Associated with Clopidogrel
- Clopidogrel
- Plavix®
Brand Names Associated with Etravirine
- Etravirine
- Intelence®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 11, 2023
Interaction Effect
Reduction in clinical efficacy of clopidogrel
Interaction Summary
Clopidogrel is metabolized to its active metabolite by CYP2C19. Although the interaction between clopidogrel and etravirine has not been studied, coadministration of omeprazole, a CYP2C19 inhibitor like etravirine, with clopidogrel resulted in reduced clopidogrel active metabolite concentrations and reduced platelet inhibition. A similar interaction would be expected between clopidogrel and other CYP2C19 inhibitors. Because of the potential for reduced clopidogrel efficacy, concomitant use of CYP2C19 inhibitors, including etravirine, with clopidogrel should be avoided.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of clopidogrel and etravirine should be avoided due to the potential for reduced clopidogrel active metabolite concentrations and reduced platelet inhibition.
Mechanism Of Interaction
Inhibition of CYP2C19-mediated clopidogrel metabolism to active metabolite by etravirine
Literature Reports
A) Exposure to the active metabolite of clopidogrel was decreased by 46% on day 1 and 42% on day 5 when healthy subjects were coadministered clopidogrel at a 300-mg loading dose followed by 75 mg/day and omeprazole 80 mg (another CYP2C19 inhibitor like etravirine) compared with the same dose of clopidogrel given alone for 5 days in a crossover clinical study (n=72). Mean inhibition of platelet aggregation also decreased by 47% at 24 hours and 30% on day 5 when clopidogrel and omeprazole were given concomitantly. Results were similar when clopidogrel and omeprazole were given at the same doses, but administered 12 hours apart in another study of healthy subjects (n=72). This indicates that an interaction between clopidogrel and omeprazole is not prevented even when administering the drugs at different times .
Clopidogrel Overview
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Clopidogrel is used alone or with aspirin to prevent serious or life-threatening problems with the heart and blood vessels in people who have had a stroke, heart attack, or severe chest pain. This includes people who have percutaneous coronary intervention (PCI; angioplasty; a type of heart surgery) that may involve inserting coronary stents (metal tubes surgically placed in clogged blood vessels to improve blood flow) or who have coronary artery bypass grafting (CABG; a type of heart surgery). Clopidogrel is also used to prevent serious or life-threatening problems with the heart and blood vessels in people who have peripheral arterial disease (poor circulation in the blood vessels that supply blood to the legs). Clopidogrel is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.
Etravirine Overview
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Etravirine is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children 2 years of age and older who no longer benefit from taking other HIV medications. Etravirine is in a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). It works by decreasing the amount of HIV in the blood. Although etravirine does not cure HIV, it may decrease your chance of developing acquired immunodeficiency syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer. Taking these medications along with practicing safer sex and making other lifestyle changes may decrease the risk of transmitting (spreading) the HIV virus to other people.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.