Patient leaflet - Clopidogrel 75 mg film-coated tablets
1. What Clopidogrel Tablets is and what it is used for
Clopidogrel Tablets contains Clopidogrel and belongs to a group of medicines called antiplatelet medicinal products. Platelets are very small structures in the blood which clump together during blood clotting. By preventing this clumping, antiplatelet medicinal products reduce the chances of blood clots forming (a process called thrombosis).
Clopidogrel Tablets is taken by adults to prevent blood clots (thrombi) forming in hardened blood vessels (arteries), a process known as atherothrombosis, which can lead to atherothrombotic events (such as stroke, heart attack, or death).
You have been prescribed Clopidogrel Tablets to help prevent blood clots and reduce the risk of these severe events because:
You have a condition of hardening of arteries (also known as
atherosclerosis), and
You have previously experienced a heart attack,
stroke or have a condition known as peripheral arterial disease, or
You have experienced a severe type of chest
pain known as 'unstable angina' or 'myocardial infarction' (heart attack). For the treatment of this condition your doctor may have placed a stent in the blocked or narrowed artery to restore effective blood flow. You may also be given acetylsalicylic acid (a substance present in many medicines used to relieve pain and lower fever as well as to prevent blood clotting) by your doctor.
You have experienced symptoms of a stroke which go away
within a short period of time (also known as transient ischemic attack) or an ischemic stroke mild in severity. You may also be given acetylsalicylic acid by your doctor starting within the first 24 hours.
You have an irregular heartbeat, a condition called 'atrial
fibrillation', and you cannot take medicines known as 'oral anticoagulants' (vitamin K antagonists) which prevent new clots from forming and prevent existing clots from growing. You should have been told that 'oral anticoagulants' are more effective than acetylsalicylic acid or the combined use of Clopidogrel Tablets and acetylsalicylic acid for this condition. Your doctor should have prescribed Clopidrogrel Tablets plus acetylsalicylic acid if you cannot take 'oral anticoagulants' and you do not have a risk of major bleeding.
2. What you need to know before you take Clopidogrel Tablets
Do not take Clopidogrel Tablets
Ÿ If you are allergic (hypersensitive) to clopidogrel or any of the
other ingredients of this medicine (listed in section 6). Ÿ If you have a medical condition that is currently causing
bleeding such as a stomach ulcer or bleeding within the brain. Ÿ 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 Tablets.
Warnings and precautions
If any of the situations mentioned below apply to you, you should tell your doctor before taking Clopidogrel Tablets:
Ÿ 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).
(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. Ÿ if you have had a clot in an artery of your brain (ischemic stroke) which occurred within the last seven days. Ÿ if you have kidney or liver disease.
Ÿ if you have had an allergy or reaction to any medicine used to treat your disease.
Ÿ if you had a past medical history of non-traumatic brain hemorrhage.
While you are taking Clopidogrel Tablets:
Ÿ You should tell your doctor if a surgery (including dental) is planned.
Ÿ 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').
Ÿ 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').
Ÿ Your doctor may order blood tests.
Children and adolescents
Do not give this medicine to children because it does not work.
Clopidogrel Tablets may be taken with or without food. Other medicines and Clopidogrel Tablets
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 Tablets 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, or other antiplatelet agents,
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 Tablets 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 Tablets with food and drink
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 Tablets. If you become pregnant while taking Clopidogrel Tablets, 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 Tablets is unlikely to affect your ability to drive or to use machines.
Clopidogrel Tablets 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 medicine.
Clopidogrel Tablets contains hydrogenated castor oil
This may cause stomach upset or diarrhoea.
3. How to take Clopidogrel Tablets
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
The recommended dose, including for patients with a condition called 'atrial fibrillation' (an irregular heartbeat), is one 75 mg tablet of Clopidogrel Tablets per day to be taken orally with or without food, and at the same time each day.
If you have experienced severe chest pain (unstable angina or heart attack), your doctor may give you 300 mg or 600 mg of Clopidogrel Tablets (1 or 2 tablets of 300 mg or 4 or 8 tablets of 75 mg) once at the start of treatment. Then, the recommended dose is one 75 mg tablet of Clopidogrel Tablets per day as described above.
If you have experienced symptoms of a stroke which go away within a short period of time (also known as transient ischemic attack) or an ischemic stroke mild in severity, your doctor may give you 300 mg of Clopidogrel Tablets (1 tablet of 300 mg or 4 tablets of 75 mg) once at the start of treatment. Then, the recommended dose is one 75 mg tablet of Clopidogrel Tablets per day as described above with acetylsalicylic acid for 3 weeks. Then the physician would prescribe either Clopidogrel Tablets alone or acetylsalicylic acid alone.
You should take Clopidogrel Tablets for as long as your doctor continues to prescribe it.
If you take more Clopidogrel Tablets than you should
Contact your doctor or the nearest hospital emergency department because of the increased risk of bleeding.
If you forget to take Clopidogrel Tablets
If you forget to take a dose of Clopidogrel Tablets, but remember within 12 hours of your usual time, take your tablet straightaway and then take your next tablet at the usual time.
If you forget for more than 12 hours, simply take the next single dose at the usual time. Do not take a double dose to make up for a forgotten tablet.
If you stop taking Clopidogrel Tablets
Do not stop the treatment unless your doctor tells you so.
Contact your doctor or pharmacist before stopping.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Contact your doctor immediately if you experience:
fever, signs of infection or extreme tiredness. These may be due
to rare decrease of some blood cells.
signs of liver problems such as yellowing of the skin and/or the
eyes (jaundice), whether or not associated with bleeding which appears under the skin as red pinpoint dots and/or confusion (see section 2 'Warnings and precautions').
swelling in the mouth or skin disorders such as rashes and
itching, blisters of the skin. These may be the signs of an allergic reaction.
The most common side effect reported with Clopidogrel Tablets is bleeding. Bleeding may occur as bleeding in the stomach or bowels, bruising, haematoma (unusual bleeding or bruising under the skin), nose bleed, blood in the urine. In a small number of cases, bleeding in the eye, inside the head, the lung or the joints has also been reported.
If you experience prolonged bleeding when taking Clopidogrel Tablets
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 2 'Warnings and precautions').
Other side effects include:
Common side effects (may affect up to 1 in 10 people):
Diarrhoea, abdominal pain, indigestion or heartburn.
Uncommon side effects (may affect up to 1 in 100 people): Headache, stomach ulcer, vomiting, nausea, constipation, excessive gas in stomach or intestines, rashes, itching, dizziness, sensation of tingling and numbness.
Rare side effect (may affect up to 1 in 1000 people): Vertigo, enlarged breasts in males.
Very rare side effects (may affect up to 1 in 10,000 people): Jaundice; severe abdominal pain with or without back pain; fever, breathing difficulties sometimes associated with cough; generalised allergic reactions (for example, overall sensation of heat with sudden general discomfort until fainting); swelling in the mouth; blisters of the skin; skin allergy; sore mouth (stomatitis); decrease in blood pressure; confusion; hallucinations; joint pain; muscular pain; changes in taste or loss of taste of food.
Side effects with frequency not known (frequency cannot be estimated from the available data): Hypersensitivity reactions with chest or abdominal pain, persistent low blood sugar symptoms.
In addition, your doctor may identify changes in your blood or urine test results.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Clopidogrel Tablets
Keep this medicine out of the sight and reach of children.
Do not use Clopidogrel Tablets after the expiry date which is stated on the carton and on the blister, after EXP. The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Do not use Clopidogrel Tablets if you notice any
visible sign of deterioration.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. Contents of the pack and other information
What Clopidogrel Tablets contains
The active substance is Clopidogrel. Each tablet contains 75 mg of clopidogrel (as hydrogen sulfate)
The other ingredients are (see section 2 'Clopidogrel Tablets contains lactose' and Clopidogrel Tablets contains hydrogenated castor oil'):
Tablet Core: Lactose monohydrate, Low substituted hydroxypropyl cellulose, Silica colloidal anhydrous, Castor oil hydrogenated, Dimeticone
Tablet Coating: Hypromellose (E464), Macrogol 400, Titanium dioxide (E171), Iron oxide red (E172)
What Clopidogrel Tablets looks like and contents of the pack
Clopidogrel Tablets are pink coloured circular shaped, biconvex, coated tablet debossed “Lll” on one side of the tablet and plain on other surface.
The tablets are supplied in blister packs containing 28, 50 and 100 tablets.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder
Macleods Pharma UK Limited,
Wynyard Park House,
Wynyard Avenue,
Wynyard, Billingham,
TS22 5TB, United Kingdom
Manufacturer
Laboratori Fundacio Dau
C/ C, 12-14 Pol. Ind. Zona Franca,
08040, Barcelona,
Spain
PL 34771/0062