Drug interactions
Clopidogrel + Selexipag
Severity: Moderate
Clopidogrel and Selexipag: moderate 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 is a strong CYP2C8 inhibitor through its glucuronide metabolite, and selexipag and its active metabolite are CYP2C8 substrates. Exposure to the active metabolite of selexipag can increase markedly, raising the risk of prostacyclin-type adverse effects such as headache, diarrhea, nausea and jaw pain.
What this interaction means in plain words
Clopidogrel and Selexipag can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Clopidogrel belongs to Cardiovascular; Selexipag belongs to Cardiovascular.
Why it happens
Clopidogrel acyl-glucuronide inhibits CYP2C8, reducing metabolism of selexipag and its active metabolite.
What to do
Monitor for selexipag adverse effects and consider a reduced dosing frequency such as once daily if not tolerated, according to product labeling.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Clopidogrel
Other interactions of Selexipag
- Gemfibrozil + Selexipag Contraindicated
- Abiraterone + Selexipag Moderate
- Apalutamide + Selexipag Moderate
- Carbamazepine + Selexipag Moderate
- Cyclosporin + Selexipag Moderate
- Deferasirox + Selexipag Moderate
Frequently asked questions
Can I take Clopidogrel with Selexipag?
MediHelp rates the interaction as moderate. Clopidogrel and Selexipag can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Clopidogrel is a strong CYP2C8 inhibitor through its glucuronide metabolite, and selexipag and its active metabolite are CYP2C8 substrates. Exposure to the active metabolite of selexipag can increase markedly, raising the risk of prostacyclin-type adverse effects such as headache, diarrhea, nausea and jaw pain.
How serious is the interaction between Clopidogrel and Selexipag?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for selexipag adverse effects and consider a reduced dosing frequency such as once daily if not tolerated, according to product labeling.
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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