The use of oral suspension and rationally prescribing alternatives may be supplemental to the implementation of clopidogrel new algorithm comprising CYP2C19 pharmacogenetics and drug interactions.

Abstract

Dear editor We read with great interest the study by Saab et al,1 which shows that all patients who received combination therapy of clopidogrel and cytochrome P540 2C19 (CYP2C19) substrates require clopidogrel dose adjustment if they are not CYP2C19*1/*1 carriers and that therapeutic dose of 75 mg clopidogrel should be tailored in patients with different genotypes (eg, lowered to 6 mg or increased to 215 mg) for the sake of efficacy and safety. We especially appreciate the new clinical pharmacogenetic algorithm they developed to optimize clopidogrel-based treatment. However, we found two points worthy of discussion and would like to share our perspectives in the following paragraphs.