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clopidogrel - oral, Plavix (cont.)

PRECAUTIONS: Before taking clopidogrel, tell your doctor or pharmacist if you are allergic to it; or to other thienopyridines (such as prasugrel); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding conditions (such as stomach ulcers, bleeding in the brain/eye), recent surgery, serious injury/trauma, liver disease, bleeding disease (such as hemophilia).While you are taking this medication, it may take longer than usual for bleeding to stop if you have a cut or injury. Use caution with sharp objects like safety razors or nail cutters and avoid activities such as contact sports to lower the chance of getting cut, bruised, or injured.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor may instruct you to stop clopidogrel for 5 to 7 days before surgery. Do not stop taking clopidogrel without talking with your heart doctor (cardiologist) first.Limit alcoholic beverages. Daily use of alcohol, especially when combined with this medicine, may increase your risk for stomach bleeding.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.If you are currently taking aspirin, consult your doctor promptly and ask whether to continue or stop taking it with this medication for your specific condition (aspirin and clopidogrel may be used in combination after a coronary stent procedure, or for some heart conditions). If you are not currently taking aspirin, consult your doctor before starting it for any medical condition.Some products that may interact with this drug include: tipranavir, antidepressants (such as amitriptyline, clomipramine, SSRIs including paroxetine/citalopram, SNRIs including duloxetine/venlafaxine).Some medications may cause clopidogrel to not work as well. Examples include certain acid reducers (proton pump inhibitors/PPIs such as omeprazole, esomeprazole), fluvoxamine, fluoxetine, cimetidine, fluconazole, ketoconazole, voriconazole, etravirine, felbamate and ticlopidine, among others. Promptly ask your doctor or pharmacist for more details.Do not use non-prescription medications that contain PPIs (such as omeprazole, esomeprazole) or cimetidine for relief of upset stomach or heartburn. These medications can prevent clopidogrel from working well. Ask your doctor or pharmacist about safer alternatives such as liquid antacids, ranitidine, or famotidine.Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (nonsteroidal anti-inflammatory drugs or NSAIDs such as ibuprofen, naproxen, or aspirin) which can increase the risk of bleeding/anti-platelet effect when used with clopidogrel. Ask your pharmacist about the safe use of those products.



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