Clopidogrel use in children.
OBJECTIVE
To review a pediatric experience with the antiplatelet agent clopidogrel and suggest a dosage regimen.


METHODS
A retrospective chart review of all infants and children treated with clopidogrel at The Hospital for Sick Children, Toronto between January 2001 and April 2004. Clopidogrel dosages, duration of therapy, complications, and adverse effects in a pediatric population were explored.


RESULTS
Fifteen infants and children with congenital and acquired heart disease were treated with clopidogrel (median age, 3.5 years; range, 6 weeks to 16 years). Dosages ranged from 1 to 6 mg/kg/day for periods between 1 month and 6 months. Although no thrombotic events were reported, 1 child had a bleeding complication (gastrointestinal) while on triple antithrombotic therapy. Other complications reported in adults, including rash and clinical thrombocytopenia, were not noted in this pediatric series.


CONCLUSIONS
Clopidogrel was well tolerated. We suggest a starting dose of 1 mg/kg/day for children.
Finkelstein
Yaron
Y
Division of Clinical Pharmacology, The Hospital for Sick Children, University of Toronto School of Medicine, Toronto, Ontario. yfinkel@yahoo.com
Nurmohamed
Laila
L
Avner
Marina
M
Benson
Lee N
LN
Koren
Gideon
G
D000293:Adolescent; D006328:Cardiac Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D000077144:Clopidogrel; D004334:Drug Administration Schedule; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine