Supplementary Material for: Clopidogrel Use in Saudi Arabia: Prescription Patterns and Prevalence of Common Concurrent Medications

Background: Clopidogrel is a widely used antiplatelet agent, often prescribed alongside other medications for other comorbidities. This may elevate the risk of drug-drug interactions (DDIs), which may have detrimental effects on patient’s health. This study aims to address a gap in understanding the prescription patterns of clopidogrel in real-world settings and the prevalence of using other potential interacting medications.
Methods: This was a retrospective descriptive analysis using secondary data from the Real-world Evidence Research Network, covering the period from 2016 to 2023. The population under investigation comprises all patients who initiated clopidogrel. Data were collected on demographics, comorbidities, prescription characteristics, and concomitant medication use, specifically anticoagulants, antiplatelets, nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and statins. Concomitant drug use was defined as a complete or partial overlap of at least seven days between the use of these interacting drugs and clopidogrel prescriptions. Reliance on prescription records is a limitation due to potential data gaps but a strength for large-scale analysis in patients initiating clopidogrel.
Results: The study included 23512 patients, predominantly male (67.5%), with a mean age of 65 years. Among the 89,478 clopidogrel prescriptions, the majority (92.4%) were prescribed at the 75 mg dose. This study found that 32.05% of patients co-used statins, 28.61% used PPIs, and 22.22% used antiplatelets, highlighting significant risks of DDIs. These interactions may compromise efficacy or increase adverse outcomes, such as bleeding.
Conclusions: Clopidogrel is frequently prescribed with other potentially interacting medications such as cardiovascular and gastrointestinal agents. The potential for drug-drug interactions incidence necessitates vigilant medication management to optimize patient’s outcomes and ensure the safe and effective use of clopidogrel.