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Clopidogrel, Oral Tablet

Highlights for clopidogrel

  1. Clopidogrel oral tablet is available as both a generic and brand-name drug. Brand name: Plavix
  2. The most common side effect that occurs with clopidogrel is bleeding. This can be life-threatening. You should tell your doctors or dentists that you’re taking clopidogrel before having any procedures done. You may need to stop taking this drug for a short time before a procedure to prevent bleeding. Your doctor will let you know.
  3. Clopidogrel is used to prevent heart attack and stroke. It is prescribed for people who have had a recent heart attack or stroke or peripheral arterial disease (poor circulation in your legs).
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Important warnings

Important warnings

FDA Warning: Liver function warning
  • This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.
  • Clopidogrel is broken down by your liver. Some people have genetic differences in how one of the liver enzymes, cytochrome p-450 2C19 (CYP2C19), works. This could slow how this drug is broken down in your body and make it not work as well. Your doctor may test you to see if you have this genetic difference. If you have it, your doctor will prescribe other treatments or drugs instead of clopidogrel.
  • Serious bleeding warning: This drug can cause serious and sometimes fatal bleeding. Clopidogrel may make you bruise and bleed more easily, have nosebleeds, and it will take longer than usual for bleeding to stop. You should tell your doctor about any serious bleeding, such as:
    • unexplained, prolonged, or excessive bleeding
    • blood in your urine or stool
  • Warning for surgery or procedure: You should tell your doctors or dentists that you’re taking clopidogrel before having any procedures done. You may need to stop taking this drug for a short time before a procedure to prevent bleeding. Your doctor will let you know when to stop taking this medication and when it’s OK to take it again.

About

What is clopidogrel?

Clopidogrel oral tablet is a prescription drug that’s available as the brand-name drug Plavix. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Why it's used

Clopidogrel is used to prevent blood clots if you have chest pain, poor circulation in your legs (peripheral arterial disease), a heart attack, or stroke.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs. Your doctor will decide if you should use this drug with other drugs, such as aspirin.

How it works

Clopidogrel belongs to a class of drugs called platelet inhibitors or thienopyridine class inhibitors of P2Y12 ADP platelet receptors. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Platelets are blood cells that help your blood clot normally. Clopidogrel helps prevent platelets from sticking together. This stops them from forming blood clots.

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Side effects

Clopidogrel side effects

Clopidogrel oral tablet does not cause drowsiness. However, it does cause other side effects.

More common side effects

The more common side effects that can occur with clopidogrel include:

  • bleeding
  • itchy skin

If you have itchy skin, it may go away within a few days or a couple of weeks. If it is more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Serious, life-threatening bleeding. Symptoms can include:
    • unexplained bleeding or bleeding that lasts a long time
    • blood in your urine (pink, red, or brown-colored urine)
    • red or black stools that look like tar
    • unexplained bruises or bruises that get larger
    • coughing up blood or blood clots
    • vomiting blood or vomit that looks like coffee grounds
  • Blood-clotting problem called thrombotic thrombocytopenic purpura (TTP). This condition can happen after you take clopidogrel, even if you only take it for less than 2 weeks. In TTP, blood clots form in blood vessels anywhere in the body. Get medical help right away if you have any of these symptoms:
    • purplish spots (purpura) on your skin or in your mouth (mucous membrane) due to bleeding under the skin
    • yellowing of your skin or the whites of your eyes (jaundice)
    • tiredness or weakness
    • pale-looking skin
    • fever
    • fast heart rate or shortness of breath
    • headache
    • trouble speaking or understanding language (aphasia)
    • confusion
    • coma
    • stroke
    • seizure
    • low amount of urine, or urine that’s pink or has blood in it
    • stomach pain
    • nausea, vomiting, or diarrhea
    • vision loss

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Interactions

Clopidogrel may interact with other medications

Clopidogrel oral tablet can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with clopidogrel are listed below.

Diabetes drug

  • epaglinide

Taking clopidogrel with this drug increases the amount of repaglinide in your body, which can result in low blood sugar levels. If you must take these drugs together, your doctor will carefully manage your dosage of repaglinide.

Stomach acid drugs (proton pump inhibitors)

  • omeprazole
  • esomeprazole

You shouldn’t take clopidogrel with these drugs. They can make clopidogrel less effective.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Such as:

  • ibuprofen
  • naproxen

Taking clopidogrel with NSAIDs may increase your risk of bleeding in your stomach and intestines.

Blood thinners

  • warfarin (Coumadin, Jantoven)

Both of these medicines work to thin the blood in different ways. Taking them together increases your risk of bleeding.

Drugs used to treat depression

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs)

Using these medicines with clopidogrel may increase the risk of bleeding.

Salicylates

  • aspirin

Aspirin should be taken with clopidogrel if you have acute coronary syndrome. These medicines shouldn’t be taken together if you have had a recent stroke because they increase your risk of major bleeding.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

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Other warnings

Clopidogrel warnings

Clopidogrel oral tablet drug comes with several warnings.

Allergy warning

Clopidogrel can cause a severe allergic reaction. Symptoms may include:

  • trouble breathing
  • swelling of your face, lips, tongue, or throat

Don’t take this drug again if you’ve ever had an allergic reaction to it. You also shouldn’t take this drug if you’re allergic to thienopyridines (ticlopidine, clopidogrel). Taking it a second time after an allergic reaction could be fatal.

Alcohol interaction

Alcohol can increase your risk of bleeding while you’re taking this drug.

Warnings for people with certain health conditions

For people with active bleeding: You shouldn’t take clopidogrel if you have an active bleed (brain bleed) or a medical condition that causes bleeding (such as a stomach or bowel ulcer). Clopidogrel prevents clotting and increases your risk of bleeding.

For people with an allergy to thienopyridines: If you’ve ever had an allergic reaction to any kind of thienopyridine, you shouldn’t take clopidogrel.

For people with a recent stroke: You shouldn’t take this drug with aspirin if you’ve recently had a stroke. It can increase your risk of serious bleeding.

For pregnant women: Clopidogrel is pregnancy category B. That means two things:

  1. Studies of the drug in pregnant animals have not shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Clopidogrel should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: It isn’t known if clopidogrel passes into breastmilk. If it does, it may cause serious effects in a child who is breastfed. You and your doctor may need to decide if you’ll take clopidogrel or breastfeed.

For children: The safety and effectiveness of clopidogrel hasn’t been established in children younger than 18 years.

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Dosage

How to take clopidogrel

This dosage information is for clopidogrel oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Brand: Plavix

  • Form: Oral tablet
  • Strengths: 75 mg and 300 mg

Generic: clopidogrel

  • Form: Oral tablet
  • Strengths: 75 mg and 300 mg

Dosage for acute coronary syndrome

Adult dosage (ages 18 years and older)

  • A starting (loading) dose is 300 mg, taken by mouth one time. Starting treatment without a loading dose will delay effects by several days.
  • The maintenance dose is 75 mg, taken by mouth one time per day.

Child dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Dosage for recent heart attack, recent stroke, or peripheral arterial disease

Adult dosage (ages 18 years and older)

The recommended dose is 75 mg taken by mouth one time per day.

Child dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

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Take as directed

Take as directed

Clopidogrel oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all or miss doses: If you don’t take clopidogrel at all or miss doses, you increase your risk of heart attack or stroke. These conditions can be fatal.

If you have to temporarily stop taking clopidogrel, start taking it again as soon as your doctor tells you to. Stopping this drug may increase your risk of serious heart conditions, stroke, or a blood clot in the legs or lungs.

If you take too much: If you take too much clopidogrel, you could have serious side effects. These include bleeding. Call your healthcare provider or poison control center right away.

What to do if you miss a dose: If you miss a dose, take clopidogrel as soon as you remember. If it’s almost time for your next dose, skip the missed dose. Take only one dose at your regular time. Don’t take two doses of clopidogrel at the same time unless your doctor tells you to.

How to tell if the drug is working: This drug may be working if you don’t have a heart attack or stroke.

Important considerations

Important considerations for taking clopidogrel

Keep these considerations in mind if your doctor prescribes clopidogrel oral tablet for you.

General

  • Don’t cut or crush the tablet.
  • Not every pharmacy stocks the brand Plavix, so call ahead.
  • Most pharmacies stock the generic form of clopidogrel.

Storage

Store clopidogrel at room temperature near 77°F (25°C). This medication can be stored for a short time between 59ºF (15ºC) and 86°F (30°C). Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • Keep the original prescription label with you. You may need to show airport staff your pharmacy’s label to clearly identify the medication.
  • Don’t leave this medicine in in the car, especially when the temperature is hot or freezing.

Self-management

Your doctor will teach you and family members the symptoms of a heart attack, stroke, or blood clot in your legs or lungs. If you have symptoms of these problems, you should go to the emergency room or call 9-1-1 right away.

Clinical monitoring

Before starting treatment with clopidogrel, your doctor may do a genetic test to check your CYP2C19 genotype. The genetic test will help your doctor decide if you should take clopidogrel. Some genotypes slow how clopidogrel is broken down. If you have this kind of genotype, this drug may not work for you.

To make sure your medicine is working and is safe for you, your doctor will check the following:

  • complete blood count (CBC)
  • signs of bleeding

Hidden costs

If you’re being treated for a certain medical condition, you might have to take clopidogrel with aspirin.

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Alternatives

Are there any alternatives?

There are several medications in this class and others to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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