Why the study?
Clopidogrel and fluconazole both act on cytochrome P450 2C19, motivating study of their interaction following acute stent thrombosis after coronary angioplasty.
Does concomitant use of fluconazole and clopidogrel increase the risk of stent thrombosis in patients undergoing coronary angioplasty?
Does concomitant use of fluconazole and clopidogrel increase the risk of stent thrombosis in patients undergoing coronary angioplasty?
Concomitant use of fluconazole and clopidogrel may lead to decreased anti-thrombotic efficacy and acute stent thrombosis due to CYP2C19 interaction.
Clopidogrel-fluconazole co-use may raise early stent thrombosis risk; single case leaves interaction significance open for prospective study.
Clopidogrel is an anti-platelet that exerts its function by selectively inhibiting the binding of adenosine di-phosphate (ADP) to the P2Y12 receptor. Fluconazole is a fungistatic agent that alters fungal cell membranes. Both of these drugs act on the cytochrome P450 2C19. We report the case of an 83-year-old male that presented two days following coronary angioplasty with stent thrombosis, following the concomitant use of clopidogrel and fluconazole. We aim to study the interaction between clopidogrel and fluconazole. We hypothesize that fluconazole decreases the therapeutic level of clopidogrel, requiring an increase in dosage to achieve the same anti-thrombotic effect.
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Khoury et al. (2022) studied this question.
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