Drug interactions
Clopidogrel + Etrasimod
Severity: Major
Clopidogrel and Etrasimod: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Clopidogrel's glucuronide metabolite inhibits CYP2C8, and etrasimod is partly cleared by CYP2C8 and CYP2C9. In CYP2C9 poor metabolizers, etrasimod exposure may rise, with more bradyarrhythmia and other adverse effects.
What this interaction means in plain words
Clopidogrel and Etrasimod can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clopidogrel belongs to Cardiovascular; Etrasimod belongs to Gastrointestinal Tract.
Why it happens
Inhibition of CYP2C8 by clopidogrel acyl-glucuronide reduces etrasimod clearance, notably when CYP2C9 pathway is impaired.
What to do
Avoid the combination in patients who are known or suspected CYP2C9 poor metabolizers. In other patients, monitor heart rate and tolerability.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Clopidogrel
Other interactions of Etrasimod
- Abatacept + Etrasimod Major
- Amiodarone + Etrasimod Major
- Anagrelide + Etrasimod Major
- Anakinra + Etrasimod Major
- Anti-thymocyte + Etrasimod Major
- Asenapine + Etrasimod Major
Frequently asked questions
Can I take Clopidogrel with Etrasimod?
MediHelp rates the interaction as major. Clopidogrel and Etrasimod can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Clopidogrel's glucuronide metabolite inhibits CYP2C8, and etrasimod is partly cleared by CYP2C8 and CYP2C9. In CYP2C9 poor metabolizers, etrasimod exposure may rise, with more bradyarrhythmia and other adverse effects.
How serious is the interaction between Clopidogrel and Etrasimod?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination in patients who are known or suspected CYP2C9 poor metabolizers. In other patients, monitor heart rate and tolerability.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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