Clopidogrel (kloe-PID-oh-grel)

Used alone or together with aspirin to help prevent stroke, heart attack, and other heart problems caused by atherosclerosis (clogged arteries). This medicine is an anti-platelet drug.

Brand Name(s):

Plavix

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• You may take this medicine with or without food.
• You may take this medicine with aspirin unless your doctor tells you otherwise.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using etravirine (Intelence®), felbamate (Felbatol®), fluoxetine (Prozac®), or fluvoxamine (Luvox®). Tell your doctor if you are using medicine to treat a fungus infection (such as fluconazole, ketoconazole, voriconazole, Diflucan®, Nizoral®, or Vfend®), other blood thinners (such as ticlopidine, warfarin, Coumadin®, Jantoven®, or Ticlid®), or a stomach medicine (such as cimetidine, esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole, Aciphex®, Nexium®, Prevacid®, Prilosec®, Protonix®, Tagamet®, or Zegerid®).
• Talk with your doctor before taking aspirin or any other type of pain or arthritis medicine such as diclofenac, etodolac, ibuprofen, indomethacin, naproxen, Advil®, Aleve®, Daypro®, Dolobid®, Feldene®, Indocin®, Motrin®, Naprosyn®, Orudis®, Relafen®, or Voltaren®. Tell your doctor if you are also using fluvastatin (Lescol®), phenytoin (Dilantin®), tamoxifen (Nolvadex®), tolbutamide (Orinase®), or torsemide (Demadex®).
• If you are also taking omeprazole (Prilosec®), do not use it at the same time that you take this medicine. Talk with your doctor about using a different antacid.
• If you are using this medicine for a condition called acute coronary syndrome, your doctor may tell you to take aspirin while you are using clopidogrel. In this case, do not change the dose or stop taking the aspirin without talking to your doctor first.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have had a recent stroke (including a "mini-stroke"), or a history of bleeding problems. Tell your doctor if you plan to have surgery or a dental procedure.
• Your doctor will do genetic tests before prescribing this medicine to know if you have CYP2C19 (a liver enzyme) deficiency. This medicine may not work well for you if you have this condition.
• While you are using this medicine, if you have any kind of bleeding, it may take longer than usual to stop, especially if you hurt yourself. Stay away from rough sports or other situations where you could be bruised, cut, or injured.
• You may also have bleeding inside your body and not be aware of it. Tell your doctor if you have any unusual bleeding such as nosebleeds or blood in your urine or stools.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine at least 5 days before having surgery or other procedures (such as coronary stent procedure, dental surgery). Do not stop taking your medicine without your doctor's permission.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Check with your doctor right away if you have the following symptoms: change in mental status, dark or bloody urine, difficulty with speaking, fever, pale color of the skin, pinpoint red spots on the skin, seizures, weakness, or yellow eyes or skin. These maybe symptoms of a rare and serious condition called thrombotic thrombocytopenic purpura (TTP).
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody or black, tarry stools.
• Chest pain (not related to your disease).
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Nosebleeds.
• Pale skin.
• Pinpoint red or purple spots on skin or in the mouth.
• Problems with vision, speech, or walking.
• Red or dark brown urine.
• Seizures.
• Severe stomach pain.
• Shortness of breath, tiredness, uneven heartbeat, and yellowing of your skin or the whites of your eyes.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.
• Vomiting of blood like coffee grounds.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, nausea, stomach pain, or upset stomach.
• Headache or dizziness.
• Joint or back pain.
• Skin rash.
• Weakness.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088