Antiplatelets, clopidogrel

Clopidogrel is a prescription antiplatelet medicine. It reduces your risk of getting blood clots by affecting cells in your blood called platelets.

It's also called Plavix and Grepid.

This page covers:

When it's used

How and when to take it

Side effects

Taking it with other medicines, food and alcohol

Who may not be able to take it

When clopidogrel is used

You may be given clopidogrel if you have or have had:

• a heart attack
• unstable angina
• a stroke or transient ischaemic attack (TIA)
• peripheral arterial disease
• an operation on your heart or blood vessels, such as a coronary stent insertion

These situations mean you're at an increased chance of getting a serious blood clot. Taking clopidogrel can help reduce this risk.

Treatment may be for a few weeks or months, or it may be lifelong.

How and when to take clopidogrel

Clopidogrel comes as a tablet that you take once a day.

The usual dose is 75mg a day, although occasionally a single higher dose – such as 300mg or 600mg – may be recommended to begin with.

• Take clopidogrel at the same time each day, with or without food.
• Don't stop taking it unless advised by a doctor – sometimes you may be told to stop taking it for a short time, such as before surgery.
• If you forget to take a dose and it's more than 12 hours until you're due to take your next one, take the missed dose as soon as you remember.
• If you forget to take a dose and it's less than 12 hours until you're due to take your next one, skip the missed dose and take your next one as normal – don't take a double dose to make up for a missed one as this can be dangerous.
• If you accidentally take an extra dose or doses, contact your GP or call NHS 111 for advice.

Side effects of clopidogrel

Clopidogrel can cause side effects, but not everyone gets them.

Some side effects are listed below. Check the leaflet that comes with your medication for a full list.

Common side effects

The following are common side effects that affect between 1 in 10 and 1 in 100 people:

• bruising or bleeding under the skin
• nosebleeds
• diarrhoea
• tummy pain
• indigestion – you may be prescribed an additional medication to help prevent this
• increased bleeding from wounds

Tell your doctor if these side effects bother you or don't go away.

Serious side effects

Less common, but more serious side effects, include:

• severe bleeding or pain
• vomiting blood
• weakness or numbness in an arm or leg
• blood in your pee or blood in your poo
• an allergic reaction – this can cause a sudden, itchy rash, swelling of the lips, mouth or throat, and breathing problems

Go to your nearest accident and emergency (A&E) department if you think you're having an allergic reaction.

Speak to your doctor or call NHS 111 immediately if you have any other worrying or unusual side effects while taking clopidogrel.

Taking clopidogrel with other medicines, food and alcohol

Taking clopidogrel with other medications can affect how well either medication works, or increase your chances of getting side effects.

For example, this can happen if clopidogrel is taken with:

• aspirin – although your doctor may sometimes recommend taking both together if they think you need them to prevent blood clots
• non-steroidal anti-inflammatory painkillers (NSAIDs), such as ibuprofen – take paracetamol instead if you need pain relief
• anticoagulant medicines, such as warfarin, apixaban, dabigatran and rivaroxaban
• other types of antiplatelet medication, such as ticagrelor, dipyridamole and prasugrel
• antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as citalopram
• some indigestion medications called proton pump inhibitors (PPIs), such as omeprazole and esomeprazole

Always read the leaflet that comes with your medication to check if it's safe to take. If you're not sure, ask a pharmacist or your GP for advice.

No foods affect clopidogrel. You can drink alcohol while taking it, but try to not to drink too much because this may irritate your stomach.

Who may not be able to take clopidogrel

Check with your doctor before taking clopidogrel if you:

• have a stomach ulcer, or have had stomach ulcers in the past
• have had bleeding on your brain (brain haemorrhage)
• have haemophilia or another bleeding disorder
• have a liver or kidney problem
• have had an allergic reaction to any medication before
• are taking other medications – this can sometimes cause problems
• are pregnant or breastfeeding

Clopidogrel should only be taken by children if recommended by a specialist doctor.