Clopidogrel

Clopidogrel is used to reduce your chances of having a stroke, blood clot, or serious heart issue after experiencing a heart attack, severe chest pain (angina), or circulation problems.

Clopidogrel may also be used for other reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use these medicines exactly as directed.

Clopidogrel can be taken with or without food.

Clopidogrel is sometimes taken together with aspirin. Take aspirin only if your doctor tells you to.

Clopidogrel keeps your blood from clotting and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

You may need to stop using clopidogrel for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking clopidogrel.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Store at room temperature away from moisture and heat.

You should not use clopidogrel if you have any active bleeding, such as a stomach ulcer or bleeding in the brain.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical help if you have bleeding that does not stop, if you see blood in your urine, have black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping clopidogrel may increase your risk of a heart attack or stroke.

You should not use clopidogrel if you are allergic to it, or if you have:

• any active bleeding; or
• a stomach ulcer or bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• an ulcer in your stomach or intestines; or
• a bleeding disorder or blood clotting disorder.

Clopidogrel may not work as well if you have certain genetic factors that affect how this medicine is broken down in your body. Your doctor may do a blood test to ensure clopidogrel is suitable for you.

This medicine is not expected to harm an unborn baby. However, taking clopidogrel within 1 week before childbirth can cause bleeding in the mother. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using this medicine.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Also call your doctor at once if you have:

• nosebleeds, pale skin, easy bruising, purple spots under your skin or in your mouth;
• jaundice (yellowing of your skin or eyes);
• fast heartbeats, shortness of breath;
• headache, fever, weakness, feeling tired;
• little or no urination;
• a seizure;
• low blood sugar--headache, hunger, sweating, irritability, dizziness, fast heart rate, and feeling anxious or shaky; or
• signs of a blood clot--sudden numbness or weakness, confusion, problems with vision or speech.

Common side effects of clopidogrel may include:

• bleeding.

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.

Usual Adult Dose for Acute Coronary Syndrome:

Unstable Angina (UA)/Non-ST-Elevation Myocardial Infarction (NSTEMI):-Loading dose: 300 mg orally once-Maintenance dose: 75 mg orally once a day-Duration of therapy: Optimal duration unknown.ST-Elevation Myocardial Infarction (STEMI):-Loading dose: 300 mg orally once (OPTIONAL)-Maintenance dose: 75 mg orally once a day, with or without thrombolytics-Duration of therapy: Optimal duration unknown.Comments: -Administer this drug in combination with aspirin 75 mg to 325 mg orally once a day.-The benefit of this drug for patients who undergo primary percutaneous coronary intervention is unknown. Uses: Prevention of atherothrombotic events in patients with non-ST-segment elevation acute coronary syndrome (UA, NSTEMI, those who are to be managed medically, those who are to be managed with coronary revascularization) and STEMI.

Usual Adult Dose for Ischemic Stroke:

75 mg orally once a dayUses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Myocardial Infarction:

75 mg orally once a dayUses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Peripheral Arterial Disease:

75 mg orally once a dayUses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Take the medicine as soon as you can, but skip the missed dose if it is close to the time for your next dose. Do not take two doses at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.

Avoid alcohol. It can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

If you also take aspirin: Ask a doctor or pharmacist before using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking these products together can increase your risk of bleeding.

Sometimes it is not safe to use certain medications at the same time. Some drugs can change the levels of other drugs in your blood, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

• a stomach acid reducer such as omeprazole, Nexium, or Prilosec;
• an antidepressant such as citalopram, fluoxetine, sertraline, Cymbalta, Effexor, Lexapro, Pristiq, or Prozac;
• rifampin;
• a blood thinner--warfarin, Coumadin, Jantoven; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect clopidogrel, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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