Do not take Clopidogrel

• If you are allergic (hypersensitive) to clopidogrel or any of the other ingredients of this medicine (listed in section 6).
• If you have a medical condition that is currently causing bleeding such as a stomach ulcer or bleeding within the brain;
• If you suffer from severe liver disease.

If you think any of these apply to you, or if you are in any doubt at all, consult your doctor before taking Clopidogrel.

Warnings and precautions

Talk to your doctor or pharmacist before taking Clopidogrel:

• if you have a risk of bleeding such as
  • a medical condition that puts you at risk of internal bleeding (such as a stomach ulcer).
  • a blood disorder that makes you prone to internal bleeding (bleeding inside any tissues, organs or joints of your body).
  • a recent serious injury.
  • a recent surgery (including dental).
  • a planned surgery (including dental) in the next seven days.
• if you have had a clot in an artery of your brain (ischemic stroke) which occurred within the last seven days.
• if you have kidney or liver disease.
• if you have had an allergy or reaction to any medicine used to treat your disease.
• if you had a past medical history of non-traumatic brain hemorrhage.

While you are taking Clopidogrel:

• You should tell your doctor if a surgery (including dental) is planned.
• You should also tell your doctor immediately if you develop a medical condition (also known as Thrombotic Thrombocytopenic Purpura or TTP) that includes fever and bruising under the skin that may appear as red pinpoint dots, with or without unexplained extreme tiredness, confusion, yellowing of the skin or eyes (jaundice) (see section 4 ‘Possible side effects’).
• If you cut or injure yourself, it may take longer than usual for bleeding to stop. This is linked to the way your medicine works as it prevents the ability of blood clots to form. For minor cuts and injuries e.g. cutting yourself shaving, this is usually of no concern. However, if you are concerned by your bleeding, you should contact your doctor straightaway (see section 4 ‘Possible side effects’).
• Your doctor may order blood tests.

Children and adolescents

Do not give this medicine to children because it does not work.

Other medicines and Clopidogrel

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription. Some other medicines may influence the use of Clopidogrel or vice versa.

You should specifically tell your doctor if you take

• medicines that may increase your risk of bleeding such as:
  • oral anticoagulants, medicines used to reduce blood clotting.
  • a non-steroidal anti-inflammatory medicine, usually used to treat painful and/or inflammatory conditions of muscle or joints.
  • heparin or any other injectable medicine used to reduce blood clotting.
  • ticlopidine, other antiplatelet agent.
• a selective serotonin reuptake inhibitor (including but not restricted to fluoxetine or fluvoxamine), medicines usually used to treat depression.
• rifampicin (used to treat severe infections).
• omeprazole or esomeprazole, medicines to treat upset stomach.
• fluconazole or voriconazole, medicines to treat fungal infections.
• efavirenz, or other anti-retroviral medicines (used to treat HIV infections).
• carbamazepine, a medicine to treat some forms of epilepsy.
• moclobemide, medicine to treat depression.
• repaglinide, medicine to treat diabetes.
• paclitaxel, medicine to treat cancer.
• opioids: while you are treated with clopidogrel, you should inform your doctor before being prescribed any opioid (used to treat severe pain).
• rosuvastatin (used to lower your cholesterol level).

If you have experienced severe chest pain (unstable angina or heart attack), transient ischemic attack or ischemic stroke in mild severity, you may be prescribed Clopidogrel in combination with acetylsalicylic acid, a substance present in many medicines used to relieve pain and lower fever. An occasional use of acetylsalicylic acid (no more than 1,000 mg in any 24 hour period) should generally not cause a problem, but prolonged use in other circumstances should be discussed with your doctor.

Clopidogrel with food and drink

Clopidogrel may be taken with or without food.

Pregnancy and breast-feeding

It is preferable not to take this product during pregnancy. If you are pregnant or suspect that you are pregnant, you should tell your doctor or your pharmacist before taking Clopidogrel. If you become pregnant while taking Clopidogrel, consult your doctor immediately as it is recommended not to take clopidogrel while you are pregnant.

You should not breast-feed while taking this medicine. If you are breast-feeding or planning to breast-feed, talk to your doctor before taking this medicine.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

Clopidogrel is unlikely to affect your ability to drive or to use machines.

Clopidogrel contains lactose. If you have been told by your doctor that you have an intolerance to some sugars (e.g. lactose), contact your doctor before taking this medicinal product.

Clopidogrel contains hydrogenated castor oil

This may cause stomach upset or diarrhoea.