Clopidogrel

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.

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 Clopidogrel 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 Clopidogrel at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause joint pain; it may cause indigestion; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause flu-like symptoms. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

75 mg
Each pink, round, biconvex, film-coated tablet, engraved with "CL" over "75" on one side and "APO" on the other, contains clopidogrel bisulfate equivalent to 75 mg of clopidogrel. Nonmedicinal ingredients: anhydrous lactose, methylcellulose, crospovidone, colloidal silicon dioxide, zinc stearate, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, polyethylene glycol, titanium dioxide, and red ferric oxide (orange shade).

300 mg
Each pink, oblong, biconvex, coated tablet, engraved with "CL 300" on one side and "APO" on the other, contains clopidogrel bisulfate equivalent to 300 mg of clopidogrel. Nonmedicinal ingredients: anhydrous lactose, methylcellulose, crospovidone, colloidal silicon dioxide, zinc stearate, hydroxypropyl cellulose, hydroxypropylmethyl cellulose, polyethylene glycol, titanium dioxide, and red ferric oxide (orange shade).

Do not take clopidogrel if you:

• are allergic to clopidogrel or any ingredients of the medication
• have an active bleeding condition such as a stomach ulcer or a brain hemorrhage
• have significant liver disease or cholestatic jaundice
• are taking the medication Repaglinide

There may be an interaction between clopidogrel and any of the following:

• acetylsalicylic acid (ASA)
• Amiodarone
• Anagrelide
• anticoagulants (e.g., Apixaban, dabigatran, Edoxaban, Enoxaparin, Heparin, Rivaroxaban, Warfarin)
• antiplatelet medications (e.g., clopidogrel, prasugrel, Ticagrelor, ticlopidine)
• Apalutamide
• "azole" antifungals (e.g., fluconazole, ketoconazole, Voriconazole)
• Bupropion
• cannabis
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Cobicistat
• Desloratadine
• Dipyridamole
• Enzalutamide
• Fentanyl
• ginger
• ginkgo biloba
• ginseng
• glucosamine
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• Moclobemide
• Morphine
• multivitamins with or without minerals
• nonsteroidal anti-inflammatories (NSAIDs; e.g., ibuprofen, Diclofenac, Ketorolac, naproxen)
• Obinutuzumab
• omega-3 fatty acids
• oseltamivir
• Paclitaxel
• Pentosan polysulfate sodium
• Pentoxifylline
• Pioglitazone
• certain protein kinase inhibitors (e.g., Dabrafenib, Dasatinib, Pazopanib)
• proton pump inhibitors (PPIs; e.g., Esomeprazole, lansoprazole, omeprazole, Pantoprazole)
• repaglinide
• rifampin
• Rosuvastatin
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin-norepinephrine reuptake inhibitors (SNRIS; Desvenlafaxine, Duloxetine, Venlafaxine)
• tipranavir
• Topotecan
• vitamin E

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Clopidogrel. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Clopidogrel.

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., certain antidepressants, NSAIDs) may further increase the risk of bleeding. If you have a history of bleeding disorders, discuss with your doctor how Clopidogrel may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clopidogrel, 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 Clopidogrel.

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 Clopidogrel may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clopidogrel, and whether any special monitoring is needed.

Kidney function: If you have reduced kidney function or Kidney Disease, discuss with your doctor how Clopidogrel may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clopidogrel, and whether any special monitoring is needed.

Lactose intolerance: Clopidogrel contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take Clopidogrel.

Liver function: Liver disease or decreased liver function can affect how Clopidogrel works for you. If you have reduced liver function or liver disease, discuss with your doctor how Clopidogrel may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Clopidogrel, 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 several 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 Clopidogrel, 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 Clopidogrel, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Clopidogrel have not been established for children.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you remember missing a dose within 12 hours of the time it is usually taken, take it as soon as you remember, then take the next dose at the regularly scheduled time. If the dose is missed by more than 12 hours, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Avoid grapefruit and grapefruit juice during your treatment. Grapefruit can seriously affect how this medication works.