Clopidogrel desensitization protocol

Time	Dose (mg)	Concentration (mg/mL)*	Amount given (mL)
8:00 AM	0	0	0.01
8:30 AM	0.005	0.5	0.01
9:00 AM	0.01	0.5	0.02
9:30 AM	0.02	0.5	0.04
10:00 AM	0.04	0.5	0.08
10:30 AM	0.08	0.5	0.16
11:00 AM	0.16	0.5	0.32
11:30 AM	0.3	0.5	0.6
12:00 PM	0.6	0.5	1.2
12:30 PM	1.2	5	0.24
1:00 PM	2.5	5	0.5
1:30 PM	5	5	1
2:00 PM	10	5	2
2:30 PM	20	5	4
3:00 PM	40	5	8
3:30 PM	75	75 mg tablet	N/A

Refer to the UpToDate topic on hypersensitivity reactions to clopidogrel for specific information about the types of reactions for which clopidogrel desensitization has been performed, preparation of the patient, and risks and benefits of the procedure.

* Clopidogrel can be solubilized by different methods. (1) Finely crushed clopidogrel may be combined with a small amount of Ora-Plus compounding agent and then diluted with Ora-Sweet to final concentrations of 0.5 and 5 mg/mL. (2) Ethanol may be used as a solvent to dissolve finely crushed clopidogrel, which is then titrated to 0.5 and 5 mg/mL using purified drinking water. All solutions should be prepared just before use.

Reproduced from: von Tiehl KF, Price MJ, Valencia R, et al. Clopidogrel desensitization after drug-eluting stent placement. J Am Coll Cardiol 2007; 50:2039. Table used with the permission of Elsevier Inc. All rights reserved.

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Clopidogrel desensitization protocol