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Clopidogrel use in children
Yaron Finkelstein1, Laila Nurmohamed, Marina Avner
1Division of Clinical Pharmacology, The Hospital for Sick Children, University of Toronto School of Medicine, Toronto, Ontario. yfinkel@yahoo.com
Insights
Clopidogrel is a safe antiplatelet agent for pediatric patients with heart conditions. A suggested starting dose of 1 mg/kg/day is recommended for children, with minimal adverse effects observed.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Hematology
Background:
- Antiplatelet agents are crucial in managing pediatric cardiovascular diseases.
- Clopidogrel's efficacy and safety in pediatric populations require further investigation.
Purpose of the Study:
- To review the clinical experience with clopidogrel in infants and children.
- To propose an appropriate dosage regimen for pediatric use.
Main Methods:
- Retrospective chart review of pediatric patients treated with clopidogrel.
- Analysis of dosages, treatment duration, complications, and adverse events.
Main Results:
- Fifteen pediatric patients received clopidogrel (median age 3.5 years).
- Dosages ranged from 1-6 mg/kg/day for 1-6 months.
- One gastrointestinal bleeding event occurred during triple antithrombotic therapy; no other common adult adverse effects were noted.
Conclusions:
- Clopidogrel demonstrated good tolerability in the pediatric cohort.
- A starting dose of 1 mg/kg/day is suggested for pediatric patients.
Objectives:
To review a pediatric experience with the antiplatelet agent clopidogrel and suggest a dosage regimen.
Study Design:
A retrospective chart review of all infants and children treated with clopidogrel at The Hospital for Sick Children, Toronto between January 2001 and April 2004. Clopidogrel dosages, duration of therapy, complications, and adverse effects in a pediatric population were explored.
Results:
Fifteen infants and children with congenital and acquired heart disease were treated with clopidogrel (median age, 3.5 years; range, 6 weeks to 16 years). Dosages ranged from 1 to 6 mg/kg/day for periods between 1 month and 6 months. Although no thrombotic events were reported, 1 child had a bleeding complication (gastrointestinal) while on triple antithrombotic therapy. Other complications reported in adults, including rash and clinical thrombocytopenia, were not noted in this pediatric series.
Conclusions:
Clopidogrel was well tolerated. We suggest a starting dose of 1 mg/kg/day for children.
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