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Why it's used

Clopidogrel is used to reduce the rate of stroke and heart attack. This medicine works by preventing the blood clot formation. Clopidogrel is also used to treat poor circulation in the legs (peripheral arterial disease) and chest pain due to heart problems, and to prevent conditions like irregular heartbeat and sudden reduction of blood flow to the heart.
Clopidogrel may also be used together with other medicines to treat certain conditions as recommended by the doctor. It is used in combination with Aspirin to lower the chances of heart attack, stroke, or blood clot formation.
Antiplatelet
Clopidogrel is a prescription medicine that belongs to a class of medicines called Antiplatelet. An antiplatelet drug is used for the treatment and prevention of heart attacks, stent thrombosis, and stroke caused by a blood clot. These medicines decrease the ability of platelets to stick together and hence reduce the formation of blood clots.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Clopidogrel. Eat this medicine as per your doctor's instructions.
Clopidogrel is eaten with or without food.

Typical Dosage

The typical adult dose of Clopidogrel is 75 mg/day. Clopidogrel is typically used at the same time every day. There are no known habit-forming tendencies with this medicine.
This medicine should be used on an as-needed basis. You should continue to use this medicine as directed by the doctor even if you feel well.

Talk to Your Doctor

Tell your doctor if your condition worsens. Talk to your doctor if blood in the urine, black colored stools, vomiting with blood, and blood clot formation. Consult with your doctor before stopping the use of Clopidogrel.
When stopping this medicine, it is possible that you may experience withdrawal symptoms such as heart attack, and stroke.

Use in Children

The safety and effectiveness of using this medicine in children has not been established. This medicine does not work in children.

Storage

Store Clopidogrel at room temperature 25° C (77° F), away from moisture, and away from light. Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Clopidogrel for symptoms for which it was not prescribed. Do not give Clopidogrel to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Clopidogrel

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Clopidogrel depends on the following factors:
  • patient's age
  • medicines recommended by your doctor
  • any other medicines in use
  • herbal supplements consumed

Clopidogrel Dosage

Dosage for irregular heartbeat (atrial fibrillation)

Adult
  • Recommended: 75 mg/day

Dosage for blood flow reduction to the heart

Adult
  • Recommended: 75 mg once daily
  • Initial: 300 mg loading dose
  • Maximum: acute coronary syndrome

Dosage for heart attack

Adult
  • Recommended: 75 mg once daily

Dosage for stroke

Adult
  • Recommended: 75 mg once daily

Dosage for poor blood circulation in the legs

Adult (peripheral arterial disease)
  • Recommended: 75 mg once daily

Forms

Tablet
Strength: 75 mg, and 300 mg
Tablet, Film coated
Strength: 75 mg, and 300 mg

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed dose.

Overdose

What to do if you overdose on Clopidogrel?
No specific antidote is available for the Clopidogrel. In the case of overdose, another alternative method called platelet transfusion may be used to reverse the effects (prolonged bleeding time) of Clopidogrel.
Symptoms of an overdose of Clopidogrel
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
If you think you have overdosed on Clopidogrel, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Clopidogrel

Before you use Clopidogrel, tell your doctor of your medical and health history including the following:
  • allergic to Clopidogrel
  • bleeding problems
  • bleeding within the brain
  • kidney disease
  • plan to have surgery and dental procedures
  • severe liver disease
  • stomach ulcers
Use of Clopidogrel in these existing conditions may lead to an increased risk of bleeding.
Before you use Clopidogrel, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to clopidogrel, ticlopidine, or prasugrel.
Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.

Use when Pregnant

Clopidogrel should be used only when required in patients who are pregnant or planning to become pregnant. Clopidogrel should be used in pregnancy only if it is needed because no adequate and well-controlled studies have been carried out.

If Breastfeeding

Consult with your doctor on the use of Clopidogrel during breastfeeding. It is unknown whether Clopidogrel passes into the breast milk.

If trying to Conceive

Consult with your doctor on the use of Clopidogrel, if you are trying to conceive. It is unknown whether this medicine will harm the unborn baby.

Seizures

Clopidogrel may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may cause stomach bleeding. Regular use of tobacco or alcohol may increase the risk. Discuss with your doctor if you smoke and drink alcohol regularly.

Clopidogrel Side-effects

The following side-effects may commonly occur when using Clopidogrel. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Clopidogrel may cause the following side-effects:
The following severe side-effects may also occur when using Clopidogrel:
  • Brain related disorders
    Symptoms: confusion, hallucinations bleeding inside the brain (intracranial bleeding)
  • Immune system disorders
    Symptoms: life-threatening allergic reactions (anaphylactoid reactions) allergic reaction to an injection of foreign protein
  • Liver disorders
    Symptoms: acute liver failure, inflammation of the liver (hepatitis) blood creatinine increased
  • Stomach and intestinal disorders (possibly fatal)
    Symptoms: inflammation of the large intestine (colitis), inflammation in the pancreas (pancreatitis), painful swelling and sores inside the mouth, bleeding behind the peritoneum space (retroperitoneal hemorrhage) stomach ulcers
  • Blood and lymphatic system disorders (possibly fatal)
    Symptoms: deficiency of granulocytes in the blood, deficiency of blood cells (aplastic anemia), deficiency of red blood cells, white blood cells, and platelets (pancytopenia), clot formation in the small blood vessels, life-threatening blood disorder (acquired hemophilia A), low count of thrombocytes in the blood, low count of neutrophils in the blood, decreased number of white blood cells high levels of eosinophils in the blood
  • Symptoms: tightening of the muscles of the lungs (bronchospasm), inflammation within the lungs (interstitial pneumonitis), build-up of white blood cells in the lungs (eosinophilic pneumonia), coughing up of blood (haemoptysis) bleeding from the lung (pulmonary hemorrhage)
  • Skin and subcutaneous tissue disorders
    Symptoms: skin allergic reaction caused by infection (erythema multiforme), life-threatening drug-induced skin reaction, swelling in the lower layer of skin, drug induced life-threatening allergic reaction, fluid-filled blisters on the skin (bullous dermatitis) severe skin reaction (Stevens-Johnson Syndrome)
  • Blood vessel disorders
    Symptoms: inflammation of a blood vessel (vasculitis), low blood pressure bleeding (haemorrhage) after surgical procedure
  • Heart disorders
    Symptoms: chest pain or heart attack due to allergic reaction (kounis syndrome)
  • Bone disorders
    Symptoms: bleeding into joint spaces (haemarthrosis)
Your doctor has prescribed this Clopidogrel because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Clopidogrel.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Patients using CYP2C19 Inhibitors

Patients having poor metabolic activity are at an increased risk when using this medicine. Use of Clopidogrel with omeprazole decreases the blood clotting activity of Clopidogrel in patients with abnormal metabolism. Avoid the use of CYP2C19 inhibitors (omeprazole or esomeprazole) in such patients. Use another platelet inhibitors (P2Y12) in patients having poor metabolic activity.

Bleeding Disorders

Patients who are taking thienopyridines are at an increased risk of bleeding. Thienopyridines may lead to blockage of blood clotting activity for 7-10 days. The process of platelet transfusion should be followed within 4 hours of starting dose or 2 hours of the maintenance dose.

Discontinuation of Clopidogrel

Patients who discontinue Clopidogrel therapy may at an increased risk of heart diseases.

Bleeding Disorder

Patients with bleeding disorder with clotting in small blood vessels are at an increased risk when using this medicine. This condition may cause low thrombocytes in the blood, deficiency of red blood cells (microangiopathic hemolytic anemia), fever, and kidney disorders. This condition requires urgent medical treatment including exchange of blood proteins (plasmapheresis).

Allergic Reaction among Thienopyridines

Patients who are taking thienopyridines are at an increased risk of allergic reactions. This allergic condition may lead to side effects such as swelling of the lower layer of the skin, low thrombocytes in the blood, skin rash, deficiency of neutrophils in the blood, and life-threatening allergic reaction. Regular monitoring for signs of allergic reaction in patients with a known allergy to thienopyridines is recommended.

Life-Threatening Blood Disorder

The patients who are using Clopidogrel are at an increased risk of a life-threatening blood disorder (acquired haemophilia). Proper management by specialists or discontinuation of Clopidogrel is required in such patients.

Recurrent Episodes of Stroke

Patients with the continual episodes of stroke are at an increased risk when using this medicine. Avoid the use of Clopidogrel during the first seven days after an incidence of stroke.

Abnormal Functioning of the Kidney

Patients with abnormal functioning of the kidney are at an increased risk when using this medicine. Such patients should take necessary precautions while taking Clopidogrel.

Abnormal Functioning of the Liver

Patients with liver disease are at an increased risk when using this medicine. Take necessary precautions while using Clopidogrel.

Patients Using CYP2C8 Substrates

Patients using CYP2C8 substrates (repaglinide) are at an increased risk while using this medicine. The use of Clopidogrel with repaglinide may increase the level of repaglinide in the body. Patients should take necessary precautions while taking both drugs in combination.

Patients with Pathological Conditions

Patients undergoing surgery or trauma are at an increased risk of bleeding when using this medicine. Patients should carefully monitor for any signs of bleeding, especially during the first week of treatment and after surgery.

Use of NSAIDs

Patients using NSAIDs (Non-steroidal anti-inflammatory drugs) with Clopidogrel may increase the risk of bleeding. Such patients should take necessary precautions while using NSAIDs with Clopidogrel especially during the first weeks of therapy.

Use of Oral Anticoagulants

Patients who are taking Clopidogrel with oral anticoagulants (warfarin) may increase the risk of bleeding. The combined use of Clopidogrel with oral anticoagulants is not recommended.

Planning to have Surgery

Such patients are at an increased risk when using this medicine. Discontinue the use of Clopidogrel seven days before undergoing the surgical procedure.

Interactions with Clopidogrel

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Clopidogrel. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

NSAIDs

Clopidogrel may interact with nonsteroidal anti-inflammatory drugs, which are used to treat pain, fever, swelling, and inflammation. The combined use of Clopidogrel with nonsteroidal anti-inflammatory drugs may increase the risk of stomach and intestinal bleeding. Patients should take necessary precautions while taking both drugs in combination.

Warfarin

There may be an interaction of Clopidogrel with warfarin, which is used to treat blood clots. The long-term use of Clopidogrel with warfarin increases the risk of bleeding. The use of Clopidogrel with warfarin is not recommended.

SSRIs and SNRIs

Clopidogrel interacts with selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, which are used to treat depression. The use of Clopidogrel with these reuptake inhibitors increases the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Repaglinide

Special instructions need to be followed while taking this medicine along with repaglinide, which is used to treat high blood sugar. Use of Clopidogrel with repaglinide may increase the level of repaglinide in the body. Take necessary precautions while taking both drugs in combination and proper dose adjustment is recommended.

Paclitaxel

Your doctor's guidelines may need to be followed while taking this medicine along with paclitaxel, which is used to treat cancer. Clopidogrel may increase the level of paclitaxel in the blood. Patients should take necessary precautions while taking both drugs in combination.

CYP2C19 Inhibitors

Clopidogrel may interact with CYP2C19 inhibitors (fluvoxamine, moclobemide, fluoxetine, voriconazole, fluconazole, ticlopidine, carbamazepine, and efavirenz), which are used to treat depression, fungal or viral infections, stroke, and seizure. Use of Clopidogrel with CYP2C19 inhibitors may decrease the level of an active metabolite of Clopidogrel. Avoid the use of CYP2C19 inhibitors in patients who are on treatment with Clopidogrel.

Proton Pump Inhibitors

There may be an interaction of Clopidogrel with proton pump inhibitors (omeprazole or esomeprazole), which are used to treat stomach ulcers. Use of these inhibitors may reduce the level of the Clopidogrel metabolites in the blood and decrease the blood clotting activity. The combined use of proton pump inhibitors and Clopidogrel should be avoided.

Dexlansoprazole, Lansoprazole, and Pantoprazole

Clopidogrel interacts with dexlansoprazole, lansoprazole, and pantoprazole, which are used to treat stomach acid production. Use of these medicines may decrease the blood clotting activity of Clopidogrel.

Glycoprotein IIb/IIIa Inhibitors

Special instructions need to be followed while taking this medicine along with glycoprotein IIb/IIIa inhibitors, which are used to prevent blood clotting. The use of Clopidogrel with glycoprotein IIb/IIIa inhibitors may increase the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Acetylsalicylic Acid

Your doctor's guidelines may need to be followed while taking this medicine along with acetylsalicylic acid, which is used to treat pain, fever, and inflammation. The use of Clopidogrel with acetylsalicylic acid may increase the risk of bleeding. Take necessary precautions while taking both drugs in combination.

Heparin or Thrombolytics

Clopidogrel may interact with heparin or thrombolytics, which are used to treat blood clots. The use of Clopidogrel with heparin or thrombolytics may increase the risk of bleeding. Patients should take necessary precautions while taking both drugs in combination.

Pentoxifylline

There may be an interaction of Clopidogrel with pentoxifylline, which is used to treat muscle pain. The use of Clopidogrel with pentoxifylline increases the risk of bleeding. Such patients should take necessary precautions while using pentoxifyllin with Clopidogrel especially during the first weeks of therapy.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Clopidogrel is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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