Last reviewed 2026-04-22 · How we verify

Vorapaxar, Aspirin, and Clopidogrel

This combination therapy inhibits platelet aggregation through multiple pathways: vorapaxar blocks the protease-activated receptor-1 (PAR-1), while aspirin and clopidogrel inhibit different steps in platelet activation and clotting cascade.

This combination therapy inhibits platelet aggregation through multiple pathways: vorapaxar blocks the protease-activated receptor-1 (PAR-1), while aspirin and clopidogrel inhibit different steps in platelet activation and clotting cascade. Used for Acute coronary syndrome, Secondary prevention of cardiovascular events in patients with stable coronary artery disease or peripheral artery disease.

At a glance

Mechanism of action

Vorapaxar is a PAR-1 antagonist that prevents thrombin-induced platelet activation. Aspirin irreversibly inhibits cyclooxygenase and reduces thromboxane A2 production. Clopidogrel is a P2Y12 receptor antagonist that blocks ADP-induced platelet aggregation. Together, these three agents provide complementary antiplatelet effects to reduce thrombotic events.

Approved indications

• Acute coronary syndrome
• Secondary prevention of cardiovascular events in patients with stable coronary artery disease or peripheral artery disease

Common side effects

• Bleeding
• Dyspepsia
• Bruising
• Headache

Key clinical trials

• Vorapaxar on Thrombin Generation and Coagulability (PHASE4)
• Vorapaxar as an Add-On Antiplatelet Therapy in Patients With and Without Diabetes Mellitus (PHASE4)
• Trial to Assess the Safety and Effects of Vorapaxar in Japanese Subjects With Acute Coronary Syndrome (P04772; MK-5348-016) (PHASE2)

Primary sources

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