Clopidogrel desensitization protocol for the treatment of thienopyridine hypersensitivity

Crit Pathw Cardiol. 2007 Mar;6(1):26-9. doi: 10.1097/01.hpc.0000256476.82317.77.

Abstract

The antiplatelet agent clopidogrel has become a mainstay of treatment of patients with acute coronary syndromes and strokes, and to reduce ischemic complications after percutaneous coronary and peripheral interventions. As the use of this agent has become more widespread, hypersensitivity reactions to clopidogrel have been increasingly recognized. This problem can be difficult to manage, especially in patients who are in need of or have recently undergone intracoronary stenting, as therapeutic alternatives are limited. Our previously published experience shows that desensitization can allow clopidogrel to be used safely in these patients. The protocol is simple, rapid, and can be conducted by a team of cardiology and allergy-immunology specialists. This article outlines the procedural details of the protocol.

MeSH terms

  • Algorithms
  • Angioplasty, Balloon, Coronary
  • Clinical Protocols*
  • Clopidogrel
  • Desensitization, Immunologic / methods*
  • Drug Hypersensitivity / etiology
  • Drug Hypersensitivity / prevention & control*
  • Exanthema / chemically induced
  • Humans
  • Patient Selection
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / immunology
  • Stents
  • Ticlopidine / administration & dosage
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / immunology

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine