DLBS1033 + aspirin + clopidogrel

DLBS1033 + aspirin + clopidogrel is a combination of three agents: **DLBS1033** (a bioactive protein fraction derived from the earthworm *Lumbricus rubellus* containing lumbrokinase and related fibrinolytic proteases) with well-established antiplatelet agents **aspirin** and **clopidogrel**. DLBS1033 exerts **thrombolytic, fibrinolytic, fibrinogenolytic, and antiplatelet aggregation effects, plus reduction in blood viscosity**. Aspirin inhibits platelet aggregation via irreversible inhibition of cyclooxygenase-1 (COX-1), reducing thromboxane A2 synthesis. Clopidogrel inhibits the ADP receptor P2Y12 on platelets, blocking activation and aggregation. This combination is under study or used as an adjunct for **acute ischemic stroke, atherosclerosis, and peripheral artery disease**, aiming to enhance prevention of thrombosis and improve vascular outcomes.