Clopidogrel is an antiplatelet medicine, or blood thinner. It makes your blood flow through your veins more easily.
Clopidogrel comes as tablets and is only available on prescription.
Clopidogrel also comes in a mixed tablet with low dose aspirin. The mixed tablets are only available on prescription.
Brand names available in Ireland are:
- Clodel
- Grepid
- Iscover
- Zyllt
- Plavix
Uses of clopidogrel
Taking clopidogrel helps prevent blood clots if you have or have had:
- a heart attack
- unstable angina
- a stroke or 'mini-stroke' (transient ischaemic attack - TIA)
- peripheral arterial disease
- hardening of arteries (atherosclerosis)
- an operation on your heart or blood vessels, such as a coronary stent insertion
- irregular heartbeat (atrial fibrillation)
Check if you can take clopidogrel
You can only take clopidogrel if you’re age 18 and over.
Before your GP prescribes clopidogrel tell them if you:
- had an allergic reaction to any medicine in the past or any of the ingredients in clopidogrel
- have a medical condition that causes bleeding such as a stomach ulcer or bleeding in the brain
- have severe liver or kidney disease
- had a clot in an artery of your brain (ischaemic stroke) in the past 7 days
- had recent surgery (including dental) or you are planning to have surgery (including dental) in the next 7 days
Pregnant or breastfeeding
Do not take clopidogrel if you:
- are pregnant
- think you may be pregnant
- are trying for a baby
- are breastfeeding
Ask your GP or pharmacist for advice.
Clopidogrel and fertility
There's no clear evidence that taking clopidogrel will reduce fertility in either men or women.
Clopidogrel and contraception
Clopidogrel does not affect any type of contraception, including the combined pill and emergency contraception.
When you start taking clopidogrel
You may not notice any difference in how you feel after you start taking clopidogrel. This does not mean the medicine is not working.
Keep taking clopidogrel as your GP has told you, even if you feel well. You'll still be getting the benefits.
You may find that you bleed more easily than normal when taking clopidogrel. You may have bruising, bleeding gums, nosebleeds or heavier periods.
Urgent advice: Contact a GP immediately if:
- you are worried about any bleeding
Alcohol
Clopidogrel can irritate your stomach if you drink alcohol. Do not drink more than the weekly low-risk alcohol guidelines.
How and when to take clopidogrel
Take clopidogrel once a day, at the same time each day.
You can take it with or without food.
You may need to take clopidogrel for a few weeks or months, or you may have to take it for the rest of your life. Check this with your GP.
Don't
-
do not stop taking clopidogrel without talking to your GP first
-
do not drink grapefruit juice while taking clopidogrel - grapefruit juice decreases the effects of the medicine, so it may not work as well to prevent clots
If you take too much clopidogrel
Taking 1 or 2 extra tablets by mistake is unlikely to harm you.
Urgent advice: Contact a GP immediately if:
If you forget to take it
Do not take a double dose to make up for a forgotten dose.
If you forget to take clopidogrel, take it as soon as you remember.
If you do not remember until the following day, skip the missed dose and continue as normal.
Side effects
Talk to your GP, a pharmacist or nurse if side effects bother you or do not go away.
Common side effects
There are things you can do to manage common side effects:
Bleeding or bruising more easily
Be careful when doing activities that might cause an injury or a cut. Always wear a helmet when cycling. Wear protective gloves when you use sharp objects like scissors, knives and gardening tools.
Use an electric razor instead of wet shaving. Use a soft toothbrush and waxed dental floss to clean your teeth.
Talk to your GP if you're worried about any bleeding.
Diarrhoea
Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
Do not take any medicines to treat diarrhoea without speaking to a pharmacist or GP.
If you take the combined contraceptive pill or the progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.
Stomach pain
Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or GP.
Indigestion or heartburn
Take clopidogrel a few minutes before or after a meal. If the indigestion does not go away, it could be a sign that you have a stomach ulcer. Talk to your GP. They may prescribe something to protect your stomach or switch you to a different medicine.
Serious side effects
Serious side effects are rare.
Urgent advice: Contact your GP straight away if you:
- cough up blood or have blood in your pee, poo or vomit
- have yellowing of your skin or the whites of your eyes, have bleeding or red pinpoint dots on your skin - these can be signs of liver problems
- feel very tired or have signs of an infection, such as a high temperature or sore throat - these can be signs of a blood or bone marrow disorder
Serious allergic reaction
A serious allergic reaction (anaphylaxis) to clopidogrel is rare.
Emergency action required: Call 112 or 999 or go to an emergency department (ED) if you:
- get a rash that is itchy, red, swollen, blistered or flaky
- are wheezing
- get tightness in your chest or throat
- have trouble breathing or talking
- have swelling mouth, face, lips, tongue or throat
Read the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Taking clopidogrel with other medicines
Some medicines interfere with the way clopidogrel works. Before you start taking clopidogrel, check with your GP, a pharmacist or nurse if you’re on any other medicines or supplements.
Painkillers
Do not take aspirin for pain relief (300mg tablets) or ibuprofen while you're taking clopidogrel, unless your GP has said it's OK. They increase the chance of bleeding.
You can take paracetamol with clopidogrel.
Tell your GP you are taking clopidogrel before they prescribe any opioid such as morphine to treat severe pain.
Indigestion medicines
Do not take indigestion remedies called proton pump inhibitors (PPIs), such as omeprazole and esomeprazole. They may reduce the effect of clopidogrel.
Your GP can prescribe you a different PPI (such as lansoprazole), if you have indigestion and need a medicine to protect your stomach.
You can take other indigestion remedies such as antacids at the same time as clopidogrel.
Antidepressants
Some medicines used to treat depression called selective serotonin reuptake inhibitors (SSRIs) can increase the chance of bleeding.
Talk to a GP before starting clopidogrel if you are taking an antidepressant.
Taking clopidogrel before surgery or dental treatment
Never stop taking clopidogrel without first talking to your GP or dentist.
They'll tell you if you need to stop taking clopidgrel before a procedure.
Getting a vaccination while taking clopidogrel
You can have vaccinations while taking clopidogrel.
Tell the GP or nurse giving you the vaccine that you're taking a blood thinner.
Fact check
This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).
