Clopidogrel at a glance
Medicine class
Antiplatelet medicine; specifically an irreversible P2Y12 platelet inhibitor.
How to take it
Swallow the tablet whole with water, with or without food.
Main safety issue
Bleeding and bruising can occur more easily, and bleeding may take longer to stop.
What is Clopidogrel used for?
The selected UK product is licensed for adults in these situations:
Preventing further atherothrombotic events after a recent myocardial infarction or ischaemic stroke, or in established peripheral arterial disease.
Acute coronary syndromes, including coronary intervention or stent placement, with aspirin where specified.
Moderate- to high-risk transient ischaemic attack or minor ischaemic stroke, with aspirin and subject to licensed clinical criteria.
Preventing atherothrombotic and thromboembolic events in selected adults with atrial fibrillation who are unsuitable for vitamin K antagonists, have a low bleeding risk and receive aspirin.
How does Clopidogrel work?
Clopidogrel is a prodrug activated by liver enzymes, including CYP2C19. Its active metabolite irreversibly blocks platelet P2Y12 receptors, reducing platelet activation and aggregation for the remaining lifespan of affected platelets.
Clopidogrel preparations and strengths
Tablet
Route: Oral
Strengths: 75 mg, 300 mg
How to take Clopidogrel
Follow the pharmacy label and prescriber’s instructions. Swallow the tablet whole with water; food is optional. Do not stop clopidogrel without speaking to the prescriber, because protection from unwanted clots may be lost.
Tell doctors, dentists and pharmacists that you take clopidogrel before procedures or starting another medicine.
Avoid grapefruit juice because it may reduce clopidogrel’s effect.
Clopidogrel side effects
Common or expected effects
- Bruising or bleeding more easily, including nosebleeds, heavier periods or prolonged bleeding from cuts
- Diarrhoea
- Abdominal pain
- Indigestion or heartburn
Get urgent medical advice
- Severe, persistent or unexplained bleeding
- Blood in urine, blood or black colour in stools, coughing or vomiting blood
- Severe allergic reaction with swelling or breathing difficulty
- Jaundice or other possible liver problems
- Fever, sore throat or marked tiredness that may indicate a blood-cell disorder
- Bruising or bleeding with fever, neurological symptoms or kidney problems, which may indicate thrombotic thrombocytopenic purpura
Clopidogrel in pregnancy
Clopidogrel is not often recommended during pregnancy because human evidence is limited, but it may be necessary for some people. The selected product information advises avoiding it as a precaution. A specialist or prescriber should weigh maternal benefit against bleeding and pregnancy risks. Do not stop it without medical advice.
Clopidogrel while breastfeeding
Evidence during breastfeeding is limited. NHS and SPS guidance indicates that clopidogrel may be used cautiously for a healthy infant after professional assessment, with monitoring for poor feeding, bowel changes, skin reactions, bruising or bleeding. The selected product information advises that breastfeeding should not continue during treatment, so specialist advice is important.
Clopidogrel interactions
Check prescribed, pharmacy and complementary medicines because interactions may increase bleeding or alter clopidogrel activation.
Oral anticoagulants and other antiplatelet medicines
Combined effects may substantially increase bleeding; use only where specifically assessed and prescribed.
NSAIDs, including ibuprofen
May increase gastrointestinal and other bleeding. Do not self-treat with ibuprofen or pain-relief aspirin unless a clinician approves.
SSRIs
Their effect on platelets can add to bleeding risk.
Common questions about Clopidogrel
Answers are fully visible for fast scanning and source review.
Is clopidogrel hydrogen sulfate a blood thinner?
It is an antiplatelet medicine. It does not literally thin blood; it makes platelets less likely to stick together and form unwanted clots.
Are Plavix and clopidogrel hydrogen sulfate the same medicine?
Plavix is a brand containing clopidogrel as clopidogrel hydrogen sulfate.
Will I feel clopidogrel working?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.