Q:

11/19/2013
Any out patient oral PLAVIX (Clopidogrel) oral desensitization protocol?

A:

Thank you for your inquiry. Below you will find two sources of protocols for desensitization to clopidogrel.

Thank you again for your inquiry and we hope this response is helpful to you.

Rapid oral desensitisation procedure in clopidogrel hypersensitivity
Neth Heart J. 2008 January; 16(1): 21–23
Abstract
Clopidogrel is a selective, irreversible inhibitor of adenosine diphosphate (ADP)-induced platelet aggregation for oral use. It is a pro-drug similar to ticlopidine, which requires activation by cyctochrome P450-3A to become the active thiol derivate.

The combination of clopidogrel and aspirin is considered essential in reducing the risk of stent thrombosis in patients undergoing coronary stenting.1 This risk seems to be higher in drug-eluting stents (DES) compared with bare-metal stents (BMS).2,3 Several adverse drug reactions have been attributed to clopidogrel, varying from (urticarial) skin rashes to severe hypersensitivity syndrome with fever, neutropenia and pancytopenia.4-6 This can lead to early discontinuation of clopidogrel, and hence increase the risk of stent thrombosis.7,8

In this study we describe a successful rapid oral desensitisation procedure in a patient who developed a probable case of clopidogrel hypersensitivity.

Ann Allergy Asthma Immunol. 2006 May;96(5):756-7.Clopidogrel desensitization.
Lee-Wong M, Gadhvi D, Resnick D

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology