Moderate
Acetylsalicylic acid × Clopidogrel
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×Antiplatelet agents – P2Y12 receptor inhibitors
Mechanism
Additive antiplatelet effect via different targets: aspirin irreversibly blocks platelet cyclooxygenase; clopidogrel inhibits the P2Y12 receptor. The combination raises bleeding risk 1.5- to 2-fold versus monotherapy.
Symptoms
Gum bleeding, epistaxis, bruising without trauma. Severe cases: GI bleeding.
Management
The combination (dual antiplatelet therapy) is standard after acute coronary syndrome or coronary stenting. Limit duration to 1–6 months based on thrombosis and bleeding risk. Aspirin 75–100 mg/day. Mandatory PPI cover with pantoprazole.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- ESC: 2023 ESC Guidelines for the management of acute coronary syndromes (2023)– Eur Heart J 2023;44(38):3720–3826
- COGENT Investigators: Clopidogrel with or without Omeprazole in Coronary Artery Disease (2010)– N Engl J Med 2010;363(20):1909–1917