Clopidogrel, Oral

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KEY POINTS

• This medicine is taken by mouth to prevent blood clots. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• While taking this medicine, you may bleed more easily and it may take longer for you to stop bleeding. Avoid activities where you could be bruised, cut, or injured. This medicine may cause other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antiplatelet

Generic and brand names: clopidogrel, oral; Plavix

What is this medicine used for?

This medicine is taken by mouth to prevent blood clots, especially in people who have had heart attacks or strokes or who have diseased arteries.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Bleeding problems or blood disorders
• Liver or kidney problems
• Ulcers

Tell your provider if you have recently had a head injury or any kind of surgery.

Some people have a gene that prevents their bodies from converting this medicine into usable form. Your healthcare provider may recommend a test to check for this gene.

Females of childbearing age: Tell your healthcare provider if you are pregnant or become pregnant while taking this medicine. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as directed by your healthcare provider. This is a strong medicine that can cause serious side effects or bleeding if you take too much. Take this medicine with a glass of water.

Check with your healthcare provider before using this medicine in children under age 18.

You may take this medicine with or without food.

Do not stop taking this medicine unless your healthcare provider approves. Take it regularly each day. If you suddenly stop taking this medicine, it can increase your risk for heart attack or stroke.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: vomiting, extreme tiredness, shortness of breath, blood in your bowel movements, vomiting blood.

What should I watch out for?

While taking this medicine, you may bleed more easily and it may take longer for you to stop bleeding. Avoid activities where you could be bruised, cut, or injured. Report any unusual bruising or bleeding to your healthcare provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine. You may need to stop taking this medicine several days before surgery. Do not stop taking this medicine unless your healthcare provider tells you to.

This medicine may cause TTP, a rare condition that may be life-threatening. TTP has been reported as soon as 2 weeks after starting this medicine. If you have fever, unusual weakness, pale skin, purple spots on the skin or in and around the mouth, yellowing of the skin or eyes, or confusion, contact your healthcare provider right away.

Do not take products that contain aspirin without your healthcare provider's approval while you are taking this medicine. Aspirin may increase the risk of bleeding. Also, do not drink alcohol or take other prescription medicines, nonprescription medicines, or natural remedies unless your healthcare provider approves.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for tests and checkups.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Unusual bruising or bleeding; unusual tiredness, weakness, or paleness; red or purple spots on skin; bloody diarrhea; black, tarry bowel movements; blood in vomit or urine; fever and chills; light-colored bowel movements; dark urine; yellowing of your skin or eyes; seizures.

Other: Headache, dizziness, stomach pain, nausea, diarrhea, constipation, muscle pain, back pain, runny or stuffy nose, cough.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antibiotics such as clarithromycin (Biaxin) and erythromycin (E.E.S., Ery-Tab, Erythrocin)
• Antidepressants such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), and venlafaxine (Effexor)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antiseizure medicines such as felbamate (Felbatol), phenytoin (Dilantin, Phenytek), and topiramate (Qudexy, Topamax, Trokendi)
• Aspirin and medicines that contain aspirin (Check with your healthcare provider about low dose daily aspirin for heart disease.)
• Atomoxetine (Strattera)
• Calcium channel blockers such as amlodipine (Norvasc), amlodipine/atorvastatin (Caduet), diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), nisoldipine (Sular), and verapamil (Calan, Covera, Verelan)
• Cholesterol-lowering medicines such as fluvastatin (Lescol) and gemfibrozil (Lopid)
• Cimetidine (Tagamet)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), maraviroc (Selzentry), nelfinavir (Viracept), nevirapine (Viramune), rilpivirine (Edurant), ritonavir (Norvir), saquinavir (Invirase), stavudine (Zerit), and tipranavir (Aptivus)
• Ibrutinib (Imbruvica)
• Isoniazid
• Medicines to block or prevent stomach acid such as dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex)
• Medicines to treat or prevent blood clots such as apixaban (Eliquis), argatroban, bivalirudin, cilostazol (Pletal), dabigatran (Pradaxa), dalteparin (Fragmin), dipyridamole (Persantine), dipyridamole/aspirin (Aggrenox), edoxaban (Savaysa), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, lepirudin (Refludan), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), and warfarin (Coumadin)
• Milnacipran (Savella)
• Natural remedies such as alfalfa, anise, bilberry, bladderwrack, bromelain, cat's claw, chamomile, dong quai, evening primrose, fenugreek, feverfew, garlic, ginger, ginkgo biloba, ginseng, green tea, horse chestnut, licorice, red clover, SAMe, St. John's wort, turmeric, and willow
• Nonsteroidal anti-inflammatory medicines such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), diflunisal, etodolac, ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Stimulants such as armodafinil (Nuvigil) and modafinil (Provigil)
• Tositumomab (Bexxar)

Ask your healthcare provider or pharmacist if you need to avoid products that contain grapefruit, Seville oranges, or tangelos while you are taking this medicine. These fruits and juices can affect the way this medicine works and may increase your risk of serious side effects.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.