Clopidogrel

Clopidogrel must be changed inside your body to start working. Some bodies do not do this as well as others. If the medication does not work well, you may have a higher chance of having a heart attack or stroke. There are tests available to identify people who have trouble activating clopidogrel. Talk to your doctor about whether you should be tested. If you are found to have difficulty converting clopidogrel, your doctor may change your dose of clopidogrel or tell you not to take clopidogrel.

Your doctor or pharmacist will give you the Medication Guide. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm to obtain the Medication Guide.

Talk to your doctor about the risks of taking clopidogrel.

Clopidogrel is used to prevent repeat heart attacks or strokes in people who have had a stroke, heart attack, severe chest pain or peripheral arterial disease (poor blood flow in the blood vessels that bring blood to your legs). Clopidogrel is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.

Clopidogrel comes as a tablet to take by mouth. Take once a day with or without food. Take clopidogrel at around the same time every day. Take clopidogrel exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Clopidogrel will help prevent serious problems with your heart and blood vessels only as long as you take the medication. Continue to take clopidogrel even if you feel well. Do not stop taking clopidogrel without talking to your doctor. If you stop taking clopidogrel, there is a higher risk that you may have a heart attack or stroke. If you have a stent, stopping clopidogrel too soon can also raise the risk of a blood clot forming in the stent.

Clopidogrel is also sometimes used to prevent blood clots in people with atrial fibrillation (a condition in which the heart beats irregularly). Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking clopidogrel,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking clopidogrel. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• The following nonprescription products may interact with clopidogrel: omeprazole; esomeprazole; aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking clopidogrel. Do not start any of these medications while taking clopidogrel without discussing with your healthcare provider.
• tell your doctor if you have bleeding ulcers (sores in the lining of the stomach or small intestine), bleeding in the brain, or any other condition that causes severe bleeding. Your doctor may tell you that you should not take clopidogrel.
• tell your doctor if you were recently hurt, or if you have or have ever had liver or kidney disease. Also tell them if you have any condition that could cause bleeding, like stomach problems or ulcers.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking clopidogrel, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking clopidogrel. Your doctor may tell you to stop taking clopidogrel at least 5 days prior to your surgery to avoid excessive bleeding during surgery. Your doctor will tell you when to start taking clopidogrel again after your surgery.
• you should know that you may bleed more easily or for a longer time than usual while you are taking clopidogrel. Be careful not to cut or hurt yourself while you are taking clopidogrel.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Clopidogrel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• excessive tiredness
• headache
• dizziness
• nausea, vomiting, diarrhea
• stomach pain
• nosebleed

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• hives, rash, itching
• difficulty breathing or swallowing
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• black and tarry stools, red blood in stools
• bloody vomit, vomit that looks like coffee grounds
• unusual bleeding or bruising
• pink or brown urine
• slow or difficult speech, weakness or numbness of an arm or a leg, changes in vision, confusion
• fever; shortness of breath; fast heartbeat; purple patches or bleeding under the skin; pale skin; yellowing of the skin or eyes
• seizures

Clopidogrel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• unusual bruising or bleeding

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Plavix^®