Clopidogrel
Brand names
Usage
To reduce the risk of recurrence of heart attack or
stroke in patients diagnosed
with severe arterial disease
(atherosclerosis).
How it works
Heart attacks and strokes
occur when a
blood clot that
forms in a narrowed portion
of an artery blocks blood flow
and thus cuts off the supply
of oxygen and nutrients to
the tissue that lies beyond the
site of the clot. Clopidogrel
can prevent heart attacks and
strokes by preventing the
aggregation (clumping) of
platelets, a type of blood cell
that initiates clot formation.
Side effects
- Serious
- Gastrointestinal bleeding, fainting,
palpitations, extreme
fatigue, shortness of breath, chest pain. Seek medical help
immediately. In rare instances the medicament can block
production of white blood cells (a major component of the
immune system), leading to potentially severe
infections.
Seek medical attention promptly at the first signs of
infection, especially a high fever.
- Common
- Stomach pain,
indigestion,
diarrhea, skin
rash, itching,
flu-like symptoms, body aches or
pain,
headache,
dizziness,
joint pain,
back pain, increased risk of upper respiratory
infection.
- Less common
- General weakness, hernia, leg
cramps,
tingling and
numbness in the limbs, vomiting,
gout, arthritis,
anxiety,
insomnia,
anemia, dermatitis and skin eruptions,
bladder
infection, cataract,
conjunctivitis.
Possible interactions
- Other medicaments:
Clopidogrel may increase the effects of:
- aspirin (various), posing an increased bleeding risk.
- fluvastatin (Lescol).
- heparin and cause abnormal bleeding.
- oral anticoagulants such as warfarin (Coumadin) and
cause abnormal bleeding.
- phenytoin (Dilantin) and fosphenytoin (Cerebyx). More frequent blood levels and dosage adjustments are prudent.
- tamoxifen (Nolvadex), leading to tamoxifen toxicity.
- tolbutamide (Orinase), leading to tolbutamide toxicity.
Clopidogrel taken concurrently with:
- alendronate (Fosamax) may result in increased risk of stomach upset/diarrhea.
- cortisone like medicaments increases risk of
stomach ulcers.
- high blood pressure medicines (antihypertensives) may lessen lowering of elevated blood pressure.
- zafirlukast (Accolate) may cause additive inhibition of the CYP2C9 isoenzyme,
possibly increasing blood levels of other medicines removed by CYP2C9.
The following medicament may decrease the effects of clopidogrel:
- cholestyramine (Questran, others) might decrease the amount of clopidogrel that goes to work - separate doses by 30 minutes.
- Herbal medicines or minerals:
- Many herbal medicines may interact with aspirin.
Examples include ginkgo,
garlic,
ginger,
ginseng and
feverfew. Combining
those medicines with clopidogrel is not recommended. Talk to your doctor before adding any herbal medicine.
- Alcohol:
- Use of alcohol and clopidogrel at the same time may increase risk of
stomach damage and may prolong bleeding time.
- Discontinuation:
- Talk to your doctor before stopping this medicine for any reason.
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