There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
The FDA Drug Labels for clopidogrel (PO) do not address this question.
From the Research
Recommended Duration of Clopidogrel Therapy
The recommended duration of clopidogrel therapy following a stroke is a topic of ongoing research and debate.
- Studies have shown that dual antiplatelet therapy (DAPT) with aspirin and clopidogrel for 90 days is effective in reducing the risk of subsequent stroke in patients with minor ischemic stroke or transient ischemic attack (TIA) 1, 2.
- A systematic review and meta-analysis found that short-term DAPT (≤3 months) significantly reduced the risk of ischemic stroke recurrence and major vascular events, without increasing the risk of intracranial hemorrhage 3.
- However, prolonged DAPT (≥1 year) reduced the risk of ischemic stroke recurrence and major vascular events, but increased the risk of major bleeding and intracranial hemorrhage 3.
- Another study found that the net benefit of clopidogrel-aspirin initiated within 72 hours of symptom onset was pronounced in the first week and continued to a lesser degree in the following 2 weeks, outweighing the low but ongoing hemorrhagic risk 4.
- Time course analysis of the CHANCE trial found that clopidogrel-aspirin treatment numerically reduced the risk of ischemic stroke within the first 2 weeks, and the reduction of stroke risk from clopidogrel plus aspirin within the first 2 weeks outweighs the risk of bleeding compared with aspirin alone in patients with minor stroke or TIA 5.
Key Findings
- Dual antiplatelet therapy with aspirin and clopidogrel for 90 days is effective in reducing the risk of subsequent stroke in patients with minor ischemic stroke or TIA 1, 2.
- Short-term DAPT (≤3 months) is superior to prolonged DAPT (≥1 year) in terms of reducing the risk of ischemic stroke recurrence and major vascular events, without increasing the risk of intracranial hemorrhage 3.
- The net benefit of clopidogrel-aspirin is pronounced in the first week and continues to a lesser degree in the following 2 weeks, outweighing the low but ongoing hemorrhagic risk 4.
- Clopidogrel-aspirin treatment reduces the risk of ischemic stroke within the first 2 weeks, and the reduction of stroke risk from clopidogrel plus aspirin within the first 2 weeks outweighs the risk of bleeding compared with aspirin alone in patients with minor stroke or TIA 5.