Clopidogrel

Boxed Warning Diminished antiplatelet effect in patients with two loss-of-function alleles of the CYP2C19 gene: The effectiveness of clopidogrel results from its antiplatelet activity, which is dependent on its conversion to an active metabolite by the cytochrome P450 (CYP-450) system, principally CYP2C19. Clopidogrel at recommended doses forms less of the active metabolite and has a reduced effect on platelet activity in patients who are homozygous for nonfunctional alleles of the CYP2C19 genes (termed “CYP2C19 poor metabolizers”). Tests are available to identify patients who are CYP2C19 poor metabolizers. Consider use of another platelet P2Y 12 inhibitor in patients identified as CYP2C19 poor metabolizers. Dosage Forms Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product Tablet, Oral: Plavix: 75 mg, 300 mg [DSC] Generic: 75 mg, 300 mg Pharmacology Mechanism of Action Clopidogrel requires in vivo biotransformation to an active thiol metabolite. The active metabolite irreversibly blocks the P2Y 12 component of ADP receptors on the platelet surface, which prevents activation of the GPIIb/IIIa receptor complex, thereby reducing platelet aggregation. Platelets blocked by clopidogrel are affected for the remainder of their lifespan (~7 to 10 days). Pharmacokinetics/Pharmacodynamics Absorption Rapid, well absorbed Metabolism Extensively hepatic via esterase-mediated hydrolysis to a c...

What are the side effects of clopidogrel? The tolerability of clopidogrel is similar to that of aspirin. The more common side effects of clopidogrel are: • • • • • • • muscle aches, • • severe bleeding, • • • Ticlopidine (Ticlid) is an antiplatelet medication quite similar to clopidogrel. It has been associated with a severe reduction in white blood cell count in between 0.8% and 1% of persons. The risk of this dangerous side effect with clopidogrel is about 0.04%, much less than with ticlopidine but twice that of aspirin. Clopidogrel rarely causes a condition called thrombotic thrombocytopenic purpura (TTP) in one out of every 250,000 people. TTP is a serious condition in which blood clots form throughout the body. Blood platelets, which participate in clotting, are consumed, and the result can be bleeding because enough platelets are no longer left to allow blood to clot normally. For comparison, the related drug, ticlodipine (Ticlid), causes TTP 17-50 times more frequently than clopidogrel. SLIDESHOW Heart Disease: Causes of a Heart Attack See Slideshow What else should I know about this drug? • Clopidogrel is avaialable as tablets: 75 and 300 mg. Tablets should be stored at room temperature, 15 C - 30 C (59 F - 86 F). • Clopidogrel is available as a generic drug. You need a prescription from your doctor to obtain this medicine. • Plavix is the brand name available for clopidogrel in the US. What Is Considered Stroke-Level High Blood Pressure? Blood pressure readings ab...

Description and Brand Names Drug information provided by: US Brand Name • Plavix Descriptions Clopidogrel is used alone or together with aspirin to lessen the chance of a heart attack or stroke. It is given to patients with acute coronary syndrome (ACS), to patients who have already had a heart attack, severe chest pain, or a stroke, or to patients with other circulation problems (eg, peripheral arterial disease) that could cause a stroke or heart attack. Acute coronary syndrome is a condition where the blood flow to the heart is blocked. A heart attack or stroke may occur when a blood vessel is blocked by a blood clot. Clopidogrel is a platelet inhibitor. It reduces the chance that a harmful blood clot will form by preventing platelets from clumping together in the blood. Clopidogrel may also increase the chance of serious bleeding in some people. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: • Tablet Before Using In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription pr...

Recent Examples on the Web One 2020 study found that people taking clopidogrel had fewer cherry angiomas than others. — Sarah Fielding, Health, 9 Mar. 2023 Still, some research has found that clopidogrel may help prevent cherry angiomas. — Sarah Fielding, Health, 9 Mar. 2023 For someone like you, with no more than an average risk for bleeding, most experts would use aspirin, plus clopidogrel for six to 12 months. — Dr. Keith Roach, oregonlive, 14 Sep. 2022 Using two medicines to prevent clotting (such as aspirin plus clopidogrel, or Plavix) reduces the function of the blood-clotting cells. — Dr. Keith Roach, oregonlive, 14 Sep. 2022 People with any bleeding disorder or those who are taking medication to prevent clotting, such as warfarin, apixaban (Eliquis) or clopidogrel (Plavix), should discuss curcumin or turmeric supplements with their doctor before taking. — Dr. Keith Roach, oregonlive, 2 June 2022 Anticoagulants like warfarin, apixaban (Eliquis) and clopidogrel (Plavix) increase the likelihood of bruises, which older people even without these medications can get. — Dr. Keith Roach, oregonlive, 25 Oct. 2021 For example, patients with a certain variant of the CYP2C19 gene associated with a platelet clotting disorder do not respond to the drug Plavix ( clopidogrel), frequently prescribed to prevent clot formation. — Marlene Cimons, Washington Post, 24 Feb. 2018 For longer-term drugs such as clopidogrel, some programs will dispense the discharge prescriptions and send re...

Warnings You should not use clopidogrel if you have any active bleeding such as a 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 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. Related/similar drugs Before taking this medicine 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 Tell your doctor if you have ever had: • an ulcer in your stomach or intestines; or • a Clopidogrel may not work as well if you have certain genetic factors that affect the breakdown of this medicine in your body. Your doctor may perform a blood test to make sure clopidogrel is right 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. How should I take clopidogrel? 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....

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of clopidogrel in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of clopidogrel in the elderly. Breastfeeding There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Drug Interactions Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine...

Plavix Generic name: kloe-PID-oh-grel] Drug class: Medically reviewed by • • • • • • • What is Plavix? Plavix prevents platelets in your blood from sticking together to form an unwanted blood clot that could block an artery. Plavix is used to lower your risk of having a Plavix may also be used for purposes not listed in this medication guide. Warnings Plavix keeps your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions. Because of this drug action, Plavix can make it easier for you to bleed, even from a minor injury. You should not use this medicine if you have any active bleeding such as a Plavix 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. Do not stop taking this medicine 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. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you take Plavix. Before taking this medicine You should not use Plavix if you are allergic to clopidogrel, or if you have: • any active bleeding; or • a stomach ulcer or bleeding in the brain (such as from a Tell your doctor if you have ever had: • an ulcer in y...

This medicine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand. You may take this medicine with or without food. If you are also taking omeprazole (Prilosec®) or esomeprazole (Nexium®), do not use it at the same time that you take this medicine. Talk with your doctor about using a different antacid. Your doctor may tell you to take aspirin while you are using clopidogrel. Do not change the dose or stop taking the aspirin without talking to your doctor first. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. • For oral dosage form (tablets): • For prevention of heart attack or stroke in patients with acute coronary syndrome (ACS): • Adults—At first, 300 milligrams (mg) taken as a single dose. Then, a maintenance dose of 75 mg once a day. Your doctor may also give you aspirin together with this medicine. • Children—Use and dose must be determined by your doctor...