Clopidogrel belongs to the class of medications called platelet aggregation inhibitors or antiplatelets. Clopidogrel is used to help prevent heart attacks, strokes, and other circulation problems in people who have atherosclerosis (narrowed blood vessels caused by “hardening of the arteries”) and have already experienced at least one atherothrombotic event such as heart attack, stroke, or have been diagnosed peripheral arterial disease (problems with blood flow in the arteries). It is also used with ASA (acetylsalicylic acid) by people with acute coronary syndrome or atrial fibrillation (a fast, irregular heartbeat) to reduce the risk of heart attack or stroke.
Normally, platelets help the blood to clot when needed, such as after an injury. When arteries become narrowed by fat deposits (plaques), platelets often clump together in the vessels. Unstable plaques can rupture, leading to additional platelet clumping that can cause a larger blockage of the artery. This further narrows the arteries and increases the chances of heart attack, stroke, or other circulation problems. Clopidogrel reduces the chances of these events by preventing platelets from forming into clumps.
Each pink, film-coated, round, biconvex tablet, engraved with “CD” on one side and “75” on the other, contains clopidogrel bisulfate equivalent to 75 mg of clopidogrel. Nonmedicinal ingredients: croscarmellose sodium, hypromellose, hydrogenated castor oil, red iron oxide, mannitol, microcrystalline cellulose, polyethylene glycol, and titanium dioxide.
The recommended adult dose of clopidogrel for most conditions is 75 mg once daily. When used by people with acute coronary syndromes, a 300 mg “loading dose” is initially prescribed. After this, treatment starts with 75 mg of clopidogrel once daily along with ASA once daily.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
Clopidogrel may be taken with or without food.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose within 12 hours of your usual time, take it as soon as possible and continue with your regular dosing schedule. If it is more than 12 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not take clopidogrel if you:
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Stop taking the medication and seek immediate medical attention if any of the following occur:
HEALTH CANADA ADVISORY
July 31, 2015
Health Canada has issued new restrictions concerning the use of Plavix (clopidogrel). To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.
Allergy: Some people who are allergic to other antiplatelet medications such as ticlopidine or prasugrel also experience allergic reactions to clopidogrel. Before you take clopidogrel, tell your doctor about any previous adverse reactions you have had to medications, especially anti-platelet medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing or swelling of the face and throat.
Bleeding problems: Clopidogrel increases the risk of bleeding. Using other medications (e.g., warfarin, NSAIDs) may further increase the risk of bleeding. If you have a history of bleeding disorders, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience signs of serious or excessive bleeding (e.g., bleeding from rectum, easy bruising, bloody urine, dark stools, persistent abdominal pain and vomiting), contact your doctor immediately.
Thrombotic thrombocytopenic purpura is a rare condition that may occur while taking clopidogrel and requires immediate medical attention. Symptoms include decreased number of blood cells, reduced kidney function, and fever. Seek immediate medical attention if you experience any of these symptoms while taking this medication.
Blood glucose: When combined with clopidogrel, certain medications for type 2 diabetes (repaglinide) cause dangerously low blood glucose levels. If you have type 2 diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lactose intolerance: This medication contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take this medication.
Liver function: Liver disease or decreased liver function can affect how this medication works for you. If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
People with severely reduced liver function should not take clopidogrel.
Proton pump inhibitors: Proton pump inhibitors (PPIs) are medications such as omeprazole and lansoprazole that are taken to treat stomach ulcers and severe heartburn. When clopidogrel is taken by people who are also taking a PPI, clopidogrel may be less effective, depending on the PPI that is used. If you are taking a medication in this class, discuss with your doctor whether you should continue to take it, or whether another medication may be more appropriate.
Stomach problems: Since clopidogrel can increase the risk of bleeding and slow down the time it takes to form a clot, it is important to remind your doctor if you have had stomach ulcers. Ask the doctor or your pharmacist to review your medications if they may cause stomach ulcers (e.g., NSAIDs such as ibuprofen, naproxen, and others).
Surgery: Your doctor may want to stop clopidogrel for a few days prior to any planned surgery to prevent any unnecessary bleeding, so it is important to tell all of your doctors that you are taking clopidogrel.
Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if clopidogrel passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
There may be an interaction between clopidogrel and any of the following:
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