Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
July 31, 2015
Health Canada has issued new restrictions concerning the use of Plavix (clopidogrel). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Allergy: Some people who are allergic to other antiplatelet medications such as ticlopidine or prasugrel also experience allergic reactions to clopidogrel. Before you take clopidogrel, tell your doctor about any previous adverse reactions you have had to medications, especially anti-platelet medications. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing or swelling of the face and throat.
Bleeding problems: Clopidogrel increases the risk of bleeding. Using other medications (e.g., warfarin, NSAIDs) may further increase the risk of bleeding. If you have a history of bleeding disorders you should be monitored closely by your doctor while taking this medication.
If you have a history of bleeding disorders, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience signs of serious or excessive bleeding (e.g., bleeding from rectum, easy bruising, bloody urine, dark stools, persistent abdominal pain and vomiting), contact your doctor immediately.
Thrombotic thrombocytopenic purpura is a rare condition that may occur while taking clopidogrel and requires immediate medical attention. Symptoms include decreased number of blood cells, reduced kidney function, and fever. Seek immediate medical attention if you experience any of these symptoms while taking this medication.
Kidney function: If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Lactose intolerance: This medication contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take this medication.
Liver function: If you have reduced liver function or liver disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
People with severely reduced liver function should not take clopidogrel.
Proton pump inhibitors: Proton pump inhibitors (PPIs) are medications such as omeprazole and lansoprazole that are taken to treat stomach ulcers and severe heartburn. When clopidogrel is taken by people who are also taking a PPI, clopidogrel may be less effective, depending on the PPI that is used. If you are taking a medication in this class, discuss with your doctor whether you should continue to take it, or whether another medication may be more appropriate.
Stomach problems: Since clopidogrel can increase the risk of bleeding and slow down the time it takes to form a clot, it is important to remind your doctor if you have had stomach ulcers. Ask the doctor or your pharmacist to review your medications if they may cause stomach ulcers (e.g., NSAIDs such as ibuprofen, naproxen, and others).
Surgery: Your doctor may want to stop clopidogrel for a few days prior to any planned surgery to prevent any unnecessary bleeding, so it is important to tell all of your doctors that you are taking clopidogrel.
Pregnancy: The medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if clopidogrel passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
The safety and effectiveness of using this medication have not been established for children.