How does it work?

This medicine contains the active ingredient clopidogrel hydrogen sulphate, which is a type of medicine called an antiplatelet (sometimes referred to as a blood-thinning medicine). It stops blood cells called platelets from clumping together and forming blood clots. Clopidogrel works by preventing a natural substance called ADP from binding to its receptors on platelets. ADP is one of the chemicals in the body that cause platelets to clump together and start the process of blood clotting. As clopidogrel stops ADP from binding to platelets, it reduces the likelihood of clots forming in the blood. A blood clot that forms inside the blood vessels is known as a thrombosis and can be dangerous, as it can cause a blockage that cuts off the blood supply to an organ. A blockage in the arteries supplying blood to the heart or brain can cause a heart attack or stroke. A blockage in the blood vessels in the extremities, eg legs, may result in gangrene. Blood clots and blockages mainly result from a build up of atherosclerosis on the inside of blood vessels. Atherosclerosis is a build up of cholesterol and fat cells that narrows the blood vessels and makes their interiors rough and bumpy. This makes it more difficult for blood to flow through the vessels, and increases the likelihood of clots forming in the vessels. People who have already suffered a heart attack or stroke are at risk of having another because of the atherosclerosis in their arteries. People with unstable angina are also at risk of a heart attack because of the atherosclerosis in their arteries. Similarly, people who have narrowed arteries in their extremities, eg legs, (peripheral arterial disease) are also at risk of blood clots. These events are known as atherothrombotic events. Clopidogrel is used to prevent blood clots forming within blood vessels, and therefore reduce the risk of further atherothrombotic events in these groups of people.

What is it used for?

Reducing risk of atherothrombotic events (eg further heart attacks) in people who have had a heart attack

Reducing risk of atherothrombotic events (eg further strokes) in people who have had an ischaemic stroke

Reducing risk of atherothrombotic events (eg heart attack) in people with unstable angina

Reducing risk of atherothrombotic events in peripheral arterial disease

Warning!

The safety and efficacy of this medicine in children and adolescents under 18 years of age has not been established.

Your doctor may ask you to stop taking this medicine a week prior to planned surgery, including dental surgery, as it may prolong any bleeding. Discuss this with your doctor.

It may take longer than normal for you to stop bleeding while you are taking this medicine. Tell your doctor if you experience any unusual bleeding or unexplained bruising.

Use with caution in

Decreased kidney function

Moderate liver disease

People at risk of bleeding due to surgery, injury or disease

Not to be used in

Active bleeding, such as peptic ulcer or brain haemorrhage

Breastfeeding

First few days following a heart attack

First week following an ischaemic stroke

Severely decreased liver function

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

There is no information available about the safety of this medicine during pregnancy. It is not recommended for use during pregnancy. Seek medical advice from your doctor.

There is no information available about the safety of this medicine during breastfeeding. For this reason, the manufacturer states that it should not be used during breastfeeding. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Headache

Rash

Itching (pruritus)

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Indigestion (dyspepsia)

Bruising

Balance problems involving the inner ear (vertigo)

Bleeding (haemorrhage)

Pins and needles (paraesthesia)

Dizziness

Blood in the urine (haematuria)

Nosebleeds (epistaxis)

Decrease in the number of a type of white blood cell (neutrophil) in the blood (neutropenia)

Decrease in the number of platelets in the blood (thrombocytopenia)

Localised collection of blood (usually clotted) due to a break in the blood vessel wall (haematoma)

Ulceration or bleeding of the stomach or intestines

Small haemorrhage (bleeding) in the skin (purpura)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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