The most commonly discussed genetic polymorphism related to clopidogrel is that of one or both alleles of the CYP2C19 enzyme. Genetic polymorphisms to these enzymes can influence response to therapy. Clopidogrel is an inactive prodrug that requires enzymatic activation via a variety of CYP enzymes, including the CYP2C19 and CYP3A4 enzymes, through a two-step process of bioactivation. Inhibition of this receptor prevents the downstream activation of the glycoprotein IIb/IIIa receptor complex, which leads to reduced platelet aggregation. Clopidogrel is an irreversible inhibitor of the platelet P2Y12 adenosine diphosphate receptor.
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