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[What is the optimal dose of clopidogrel in pediatric patients?]
Cristina Mondelo García1, Cristina Martínez Roca1, Fernando Rueda Núñez2
1Departamento de Farmacia, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas. Universidade da Coruña (UDC), A Coruña, España.
Insights
Clopidogrel at 0.2mg/kg/day is safe and effective for children. This study found no adverse effects in pediatric patients receiving clopidogrel for various conditions.
Area of Science:
- Pediatric Pharmacology
- Cardiovascular Therapeutics
- Drug Safety and Efficacy
Background:
- Clopidogrel is an antiplatelet medication.
- Its use in pediatric populations requires careful evaluation.
- Understanding its safety and efficacy in children is crucial.
Purpose of the Study:
- To collect retrospective data on clopidogrel prescription in children.
- To describe the conditions of its use in a pediatric tertiary referral hospital.
- To evaluate clopidogrel's use against current scientific evidence.
Main Methods:
- Retrospective, observational, and descriptive study (March 2010-March 2017).
- Included pediatric patients (<18 years) discharged on clopidogrel.
- Collected data on demographics, diagnosis, treatment, and outcomes.
Main Results:
- 11 pediatric patients included; mean age 3.1 years.
- All received clopidogrel 0.2mg/kg/day; 10/11 received concomitant aspirin.
- No hemorrhagic complications or adverse effects were observed.
Conclusions:
- Clopidogrel 0.2mg/kg/day appears safe and effective in pediatric patients.
- Good tolerance may be linked to optimized dosing for platelet aggregation.
- Further research may confirm optimal dosing strategies in children.
Introduction:
The aim of this study was to collect retrospective data on the prescription of clopidogrel, describe the conditions of its use in the paediatric population of a tertiary referral hospital, and evaluate its use based on the current scientific evidence.
Patients And Methods:
We conducted a retrospective, observational and descriptive study between March 2010 and March 2017. We included all patients under the age of 18 who were discharged from our hospital for home treatment with clopidogrel within the study period. We collected data on the following: demographic data, diagnosis, indication for clopidogrel, start and end date of treatment, presence or absence of concomitant treatment with acetylsalicylic acid or other antiplatelet or anticoagulant drugs, concomitant treatment with proton pump inhibitors, effectiveness, and adverse effects.
Results:
The study included a total of 11 patients (45% male). The mean age was 3.1 years (range, 1 month-8 years). The prescribed dose of clopidogrel was 0.2mg/kg/day in all patients, and 10/11 patients received concomitant treatment with acetylsalicylic acid with the purpose of optimising antiplatelet therapy. None of the children received concomitant treatment with anticoagulants, and only one of them received treatment with a proton pump inhibitor. We did not find evidence of haemorrhagic complications or other adverse effects associated with clopidogrel.
Conclusion:
Based on our experience, a clopidogrel dose of 0.2mg/kg/day is a safe and effective treatment, regardless of the patient's age. The good tolerance observed in our study could be related to the adjustment of the optimal dose with the aim of achieving platelet aggregation without increasing the risk of adverse effects.
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