Usage And Safety
Side Effects
Abdominal pain, dyspepsia, gastritis, diarrhea, nausea, vomiting, constipation, gastrointestinal hemorrhage, ulceration, neutropenia, rash, palpitation, syncope, drowsiness, asthenia, neuralgia, paresthesia and vertigo.
Drug Interactions
Warfarin , Glycoprotein IIb/IIIa inhibitors , Acetylsalicylic acid (ASA) , Heparin , Thrombolytics , NSAIDs , SSRIs , omeprazole and esomeprazole, fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, carbamazepine, and efavirenz .
Indication
Secondary prevention of atherothrombotic events : Adult patients suffering from myocardial infarction (from a few days until less than 35 days), ischaemic stroke (from 7 days until less than 6 months) or establishedperipheral arterial disease. Prevention of atherothrombotic and thromboembolic events in atrial fibrillation: In adult patients with atrial fibrillation who have at least one risk factor for vascular events, are not suitable for treatment with Vitamin K antagonists (VKA) and who have a low bleeding risk, clopidogrel is indicated in combination with ASA for the prevention of atherothrombotic and thromboembolic events, including stroke.
When not to Use
1.Hypersensitivity to the active substance. 2. Active pathological bleeding such as peptic ulcer or intracranial haemorrhage. 3.Severe hepatic impairment.
Warnings
Warning 1
Acquired haemophilia: in cases of confirmed isolated activated Partial Thromboplastin Time (aPTT) prolongation with or without bleeding, acquired haemophilia should be considered. Patients with a confirmed diagnosis, clopidogrel should be discontinued.
Warning 2
Recent ischaemic stroke: Clopidogrel cannot be recommended during the first 7 days after acute ischaemic stroke .
Warning 3
Hepatic impairment: Experience is limited in patients with moderate hepatic disease who may have bleeding diatheses. Clopidogrel should therefore be used with caution in this population .
