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Drugs reference index «clopidogrel»

clopidogrel

Generic Name: clopidogrel (kloe PID oh grel)Brand Names: Plavix

What is clopidogrel?

Clopidogrel keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.

Clopidogrel is used to prevent blood clots after a recent heart attack or stroke, and in people with certain disorders of the heart or blood vessels.

Clopidogrel may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about clopidogrel?

Clopidogrel keeps your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions. Because of this drug action, clopidogrel can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of bleeding in your digestive tract. Avoid drinking alcohol while taking clopidogrel. Alcohol may increase your risk of bleeding in your stomach or intestines.

If you need to have any type of surgery or dental work, tell the surgeon or dentist ahead of time that you are using clopidogrel. You may need to stop using the medicine for at least 5 days before having surgery, to prevent excessive bleeding.

While you are taking clopidogrel, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

What should I discuss with my healthcare provider before taking clopidogrel?

Do not use this medication if you are allergic to clopidogrel, or if you have any active bleeding such as a stomach ulcer or bleeding in the brain (such as from a head injury).

Before taking clopidogrel, tell your doctor if you are allergic to any drugs, or if you have:

  • a bleeding or blood clotting disorder, such as hemophilia;

  • a history of stroke, including TIA ("mini-stroke");

  • a stomach ulcer or ulcerative colitis;

  • liver disease; or

  • kidney disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether clopidogrel passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take clopidogrel?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medication with a full glass of water.

Clopidogrel can be taken with or without food.

Because clopidogrel keeps your blood from coagulating (clotting) to prevent unwanted blood clots, it can also make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

If you need to have any type of surgery or dental work, tell the surgeon or dentist ahead of time that you are using clopidogrel. You may need to stop using the medicine for at least 5 days before having surgery, to prevent excessive bleeding.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Store clopidogrel at room temperature away from moisture and heat.

See also: Clopidogrel dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include vomiting, feeling exhausted or short of breath, and blood in your stools or vomit.

What should I avoid while taking clopidogrel?

While you are taking clopidogrel, do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

Avoid sports or activities that could result in a bruising or bleeding injury. Use extra caution to avoid cuts when brushing your teeth or shaving.

Avoid drinking alcohol while taking clopidogrel. Alcohol may increase your risk of bleeding in your stomach or intestines.

Clopidogrel side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using clopidogrel and call your doctor at once if you have any of these serious side effects:
  • nosebleed or other bleeding that will not stop;

  • black, bloody, or tarry stools;

  • coughing up blood or vomit that looks like coffee grounds;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body;

  • sudden headache, confusion, problems with vision, speech, or balance; or

  • pale skin, easy bruising or bleeding, weakness, fever, and urinating more or less than usual.

Less serious side effects may include:

  • stomach pain;

  • runny or stuffy nose, cough, sore throat; or

  • mild headache or dizziness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Clopidogrel Dosing Information

Usual Adult Dose for Ischemic Stroke:

75 mg orally once a day with or without food.Aspirin therapy should be initiated and continued in combination with clopidogrel.

Usual Adult Dose for Myocardial Infarction:

75 mg orally once a day with or without food.Aspirin therapy should be initiated and continued in combination with clopidogrel.

Usual Adult Dose for Acute Coronary Syndrome:

300 mg as an initial loading dose, followed by 75 mg orally once a day with or without food.Aspirin therapy should be initiated and continued in combination with clopidogrel.

Usual Pediatric Dose for Platelet Aggregation Inhibition:

Note: Safety and efficacy have not been established in pediatric patients; optimal dose is not known; limited dosing information is available; further pediatric studies are needed. Neonates and Infants up to 2 years: 0.2 mg/kg once daily was found to achieve a mean inhibition of platelet aggregation similar to adults receiving the recommended dose. This dose comes from the PICOLO study which included pediatric patients with a systemic-to-pulmonary artery shunt, intracardiac or intravascular stent, Kawasaki disease, or arterial graft; 79% of patients received concomitant aspirin; patients less than 2 kg and those born at less than 35 weeks gestational age were excluded (see Li, 2008). Children over 2 years of age: Optimal dose is not established; some centers use the following: Initial dose: 1 mg/kg once daily; titrate to response; in general, do not exceed adult dose.

What other drugs will affect clopidogrel?

Before taking clopidogrel, tell your doctor if you are using any of the following drugs:

  • etravirine (Intelence);

  • fluoxetine (Prozac) or fluvoxamine (Luvox);

  • tamoxifen (Nolvadex);

  • tolbutamide (Orinase);

  • torsemide (Demadex);

  • fluvastatin (Lescol);

  • certain stomach acid reducers, such cimetidine (Tagamet), esomeprazole (Nexium), dexlansoprazole (Kapidex), lansoprazole (Prevacid), omeprazole (Prilosec, Prilosec OTC, Zegerid), pantoprazole (Protonix), or rabeprazole (AcipHex);

  • an antifungal medication such as fluconazole (Diflucan), ketoconazole (Nizoral), or voriconazole (Vfend);

  • a blood thinner such as warfarin (Coumadin), heparin, dalteparin (Fragmin), enoxaparin (Lovenox), or tinzaparin (Innohep);

  • other medication used to prevent blood clots, such as alteplase (Activase), dipyridamole (Persantine), ticlopidine (Ticlid), and urokinase (Abbokinase); or

  • seizure medication such as felbamate (Felbatol) or phenytoin (Dilantin).

This list is not complete and there may be other drugs that can interact with clopidogrel. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about clopidogrel.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 7.01. Revision Date: 11/18/2009 9:26:11 AM.
  • clopidogrel Advanced Consumer (Micromedex) - Includes Dosage Information
  • Clopidogrel Professional Patient Advice (Wolters Kluwer)
  • Clopidogrel Prescribing Information (FDA)
  • Clopidogrel MedFacts Consumer Leaflet (Wolters Kluwer)
  • Plavix Prescribing Information (FDA)
  • Plavix Detailed Consumer Information (PDR)
  • Plavix Consumer Overview

See Also...

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