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Clopidogrel, developed by Mylan as a generic bioequivalent to the reference drug Plavix, is a small molecule antiplatelet agent used to prevent atherothrombotic events. It is a thienopyridine prodrug that requires hepatic metabolism by cytochrome P450 enzymes (primarily CYP2C19) to form its active thiol metabolite. This active metabolite irreversibly binds to the P2Y12 adenosine diphosphate (ADP) receptor on the platelet surface, preventing the activation of the glycoprotein IIb/IIIa receptor complex and subsequent platelet aggregation. Clopidogrel is indicated for the reduction of atherothrombotic events in adults with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease. It is also frequently used in combination with aspirin for the management of acute coronary syndrome, including both ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
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