Plavix (Clopidogrel)

Clopidogrel is used to prevent strokes and heart attacks in persons who are at high risk. In one large study, clopidogrel was more effective than aspirin in reducing heart attacks. The frequency of side effects of clopidogrel was similar to aspirin; however, stomach and intestinal bleeding probably occurs less often with clopidogrel than with aspirin.

Take clopidogrel exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with a full glass of water. Clopidogrel can be taken with or without food.

Clopidogrel is an anti-platelet drug, that is, a drug that inhibits the ability of platelets to clump together as part of a blood clot. It is similar to ticlopidine (Ticlid) in chemical structure and in the way it works. Unlike ticlopidine, clopidogrel does not cause serious reductions of white cells in the blood and, therefore, routine blood testing to determine if the white blood cell count is low is not necessary during treatment. The risk of heart attacks and strokes (which usually are caused by blood clots) is increased in patients with a recent history of stroke or heart attack and patients with peripheral vascular disease. (Peripheral vascular disease is the same as atherosclerotic arterial disease or "hardening" of the arteries in which the arteries become narrowed. It frequently occurs in the legs and often causes claudication or pain in the legs upon walking). Clopidogrel is used to reduce the risk of heart attacks and strokes in these patients. Clopidogrel was approved by the FDA in 1997.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

Tablets should be stored at room temperature, 15-30 degrees C (59-86 degrees F), away from moisture and heat.

Tell your doctor and dentist that you are taking this medication before having any surgical procedures. Do not take aspirin, ibuprofen (Motrin, Advil, Nuprin, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen (Orudis, Orudis KT, Oruvail), indomethacin (Indocin), nabumetone (Relafen), oxaprozin (Daypro), or other non-steroidal anti-inflammatory medications (NSAIDs) without first talking to your doctor. It may take longer than usual for you to stop bleeding, even from minor wounds. Tell your doctor about any unusual bleeding or bruising that you experience. Studies in rats have shown that clopidogrel appears in breast milk; however, it is not known whether it also appears in human breast milk. Because of a potential for side effects in the nursing infant, the physician must weigh the potential benefits and possible risks before prescribing clopidogrel in nursing mothers.

Get emergency medical help if you have any of these signs of an allergic reaction to Plavix: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Plavix and call your doctor at once if you have any of these serious side effects:

• nosebleed or other bleeding that will not stop;
• bloody or tarry stools, blood in your urine;
• coughing up blood or vomit that looks like coffee grounds;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• pale skin, weakness, fever, or jaundice (yellowing of the skin or eyes); or
• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin.

Your pharmacist can provide more information about Plavix.