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氯吡格雷

Clopidogrel

Clopidogrel bisulfate

血小板凝集抑制劑PO狗貓

別名: Plavix · Antiplaq · Clodian · Cloflow · Clopact · Clopivas · Clopod · Iscover · Iskimil · Nabratin · Noklot · Pleyar · Troken · SR-259990C · PCR-4099 · clopedogreli · Clopidogrel bisulfate

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

1-3 mg/kg PO once daily; if used with aspirin give lower doses (0.5-1 mg/kg PO once daily)PO· once daily
— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
As an anti-platelet agent1-3 mg/kg PO once daily; if used with aspirin give lower doses (0.5-1 mg/kg PO once daily)POonce daily—🌎 NA
Thromboprophylaxis1.1-4 mg/kgPOq24h—🌍 EU
  • Thromboprophylaxis: A single loading dose of 4-10 mg/kg p.o. may help achieve therapeutic concentrations more rapidly.

貓

適應症劑量途徑頻次療程地區
To prevent thrombus formation18.75 mg (practically, 1/4 of a 75 mg tablet) PO once dailyPOonce daily—🌎 NA
To prevent thrombus formation (combination therapy)7 mg (total dose) PO once daily in combination with aspirin 40-81 mg (total dose) every 3 days.POonce daily—🌎 NA
To prevent thrombus formation1-3 mg/kg PO once daily; if used with aspirin give lower doses (0.5-1 mg/kg PO once daily)POonce daily—🌎 NA
Thromboprophylaxis18.75 mg/catPOq24h—🌍 EU
  • To prevent thrombus formation (combination therapy): Clinical trials are needed to determine appropriate dosage and indications.
  • Thromboprophylaxis: A single loading dose of 4-10 mg/kg p.o. may help achieve therapeutic concentrations more rapidly. Administer in a gelatin capsule to improve compliance due to bitter taste.

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概覽

​氯吡格雷 (Clopidogrel)​ 是一種強效的口服血小板凝集抑制劑（屬於噻吩吡啶類），在獸醫學中廣泛用於預防危險的血栓形成。

  • ​貓科醫學​：常被用於預防患有潛在心臟病（如肥厚型心肌病）貓咪的​貓主動脈血栓栓塞症 (FATE)​。它也可能透過血管調節作用改善栓塞事件後的骨盆肢體血液循環。
  • ​犬科醫學​：用於控制與​免疫介導性溶血性貧血 (IMHA)​、蛋白質流失性腸病/腎病 (PLE/PLN) 以及腎上腺皮質機能亢進等疾病相關的高凝血狀態。

​臨床提示​：氯吡格雷的味道非常苦。如果貓咪嚐到藥錠的味道，可能會大量流口水。強烈建議將藥物放入空的明膠膠囊中餵食，以確保服藥順從性。

作用機制

Clopidogrel is a prodrug that requires hepatic biotransformation (via CYP450 enzymes) to its active, highly unstable thiol metabolite.

  • The active metabolite → binds selectively and irreversibly to the P2Y12 subtype of ADP-receptors on the platelet surface.
  • This blocks ADP binding → prevents activation of the glycoprotein IIb/IIIa complex.
  • Without this complex, platelet-fibrinogen binding cannot occur, effectively halting both primary and secondary platelet aggregation.
  • It also inhibits the release of other pro-aggregation compounds (serotonin, calcium, thromobospondin).

Because the binding is irreversible, the platelet is inhibited for its entire lifespan (approximately 7-10 days). Normal coagulation only returns as new platelets are synthesized.

安全性與警告

禁忌症

  • Active pathologic bleeding
  • Known hypersensitivity to the drug

不良反應

  • Vomiting
  • Anorexia
  • Bleeding/hemorrhage
  • Diarrhea
  • Rashes
  • Thrombotic thrombocytopenic purpura (TTP) - rare in humans

注意事項

Bleeding Risk: Use with caution in patients at risk for bleeding from trauma, surgery, or other pathological conditions. Pregnancy/Nursing: FDA Category B in humans. Probably safe in nursing veterinary patients, but weigh potential risks to offspring or use a milk replacer.

藥物相互作用

AspirinModerate

Increased risk for bleeding; however, many patients take both medications intentionally for dual antiplatelet therapy.

Heparin / Low Molecular Weight Heparins (LMWH)

Clopidogrel appears safe to use concurrently with heparin.

NSAIDs

Increased risk for bleeding; clopidogrel may interfere with NSAID metabolism.

Phenytoin

Clopidogrel may interfere with phenytoin metabolism.

Proton Pump Inhibitors (e.g., omeprazole)

May decrease the efficacy of clopidogrel by inhibiting CYP2C19, the enzyme needed to convert clopidogrel to its active metabolite.

Torsemide

Clopidogrel may interfere with torsemide metabolism.

Warfarin

Increased risk for bleeding; clopidogrel may interfere with warfarin metabolism.

AnticoagulantsMajor

High risk of bleeding complications

監測

  • Clinical efficacy (prevention of thromboembolic events)
  • Adverse effects (vomiting, anorexia)
  • Signs of bleeding (petechiae, ecchymosis, melena, epistaxis)

藥物動力學

半衰期

貓Platelet function returns to normal 7 days after stopping treatment.

吸收

In humans, rapidly absorbed with ~50% bioavailability. Food does not alter absorption.

分佈

Highly bound to plasma proteins in humans. Distributed into milk in rats.

代謝

Requires hepatic biotransformation to an active, highly unstable compound. Rapidly hydrolyzed to an inactive carboxylic acid derivative.

排除

Excreted via urine and feces.

過量

Limited information is available. Reported lethal oral doses for mice and rats were 1500 mg/kg and 2000 mg/kg, respectively.

Clinical Signs: Acute toxic signs may include bleeding or vomiting. Treatment: Platelet transfusions have been suggested if rapid reversal is required.

可用產品

劑型

  • Oral tablets
  • Compounded oral suspension

人用標示

  • Clopidogrel Bisulfate Tablets: 75 mg & 300 mg (Plavix)

各地核准狀態

European Union✓ 已核准處方藥EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 已核准處方藥VMD
🐕 Dogs🐈 Cats

POM-V

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store tablets at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Compounded oral suspensions (5 mg/mL in Ora-Plus/Ora-Sweet) retain >90% potency for 60 days at 5°C and 25°C, but must be protected from light.

飼主須知

  • ​用途​：此藥物有助於預防危及生命的血栓。
  • ​給藥方式​：可與食物一起或空腹給予。如果發生嘔吐，請與食物一起餵食。
  • ​貓咪餵藥提示​：此藥物非常苦。請勿將其壓碎或讓其在貓咪口中溶解，否則會導致嚴重流口水。強烈建議將藥丸碎片藏在空的明膠膠囊或餵藥用零食中。
  • ​出血風險​：因為它會阻止血液凝固，請注意是否有異常瘀傷、牙齦出血、流鼻血或黑色柏油狀糞便。如果發現這些跡象，請立即聯繫您的獸醫師。
  • ​食慾​：如果寵物出現食慾不振或持續嘔吐，請向獸醫師報告。

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