clopidogrel bisulfate, Plavix (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Combining clopidogrel with warfarin (Coumadin) or other drugs that cause bleeding increases the risk of bleeding.

Clopidogrel is converted to its active form by enzymes in the liver. Drugs that reduce the activity of these enzymes, for example, omeprazole (Prilosec, Zegerid) or esomeprazole (Nexium) may reduce the activity of clopidogrel and should not be used with clopidogrel. Other drugs that also may react with clopidogrel in a similar fashion include fluoxetine (Prozac, Sarafem), cimetidine (Tagamet), fluconazole (Diflucan), ketoconazole (Nizoral, Extina, Xolegel, Kuric), voriconazole (Vfend), ethaverine (Ethatab, Ethavex), felbamate (Felbatol), and fluvoxamine (Luvox).

PREGNANCY: There are no adequate studies of clopidogrel in pregnant women.

NURSING MOTHERS: 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 to nursing mothers.

SIDE EFFECTS: The tolerability of clopidogrel is similar to that of aspirin. Diarrhea, rash, or itching occurs in approximately 1 in 20 persons taking clopidogrel. Abdominal pain also occurs in about 1 in 20 persons, but it is less frequent than with aspirin. Headache, chest pain, muscle aches, and dizziness may also occur. Clopidogrel may also cause severe bleeding, allergic reactions, pancreatitis, and liver failure.



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