Plavix (Clopidogrel)

• Before starting to take Plavix and each time you get a refill, read the Medication Guide provided by your pharmacist. If you have any questions, ask your healthcare provider for clarification.
• Take Plavix by mouth with or without food as directed by your healthcare provider, usually once daily. Take this medication regularly to derive the most benefit from it. To help remember, take it at the same time each day.
• The dosage and length of treatment are determined based on your specific medical condition and your response to the treatment. If you are taking this medication to prevent clots after a stent implant or other procedure, it should be taken with aspirin for many months to years after the procedure, depending on the procedure/type of stent, as directed by your healthcare provider. Continue taking this medication even if you feel well and do not stop it without consulting your healthcare provider.
• Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your healthcare provider says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. 
• If you have any signs that this medication is not working, such as symptoms of a new heart attack or stroke (such as chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, trouble speaking, sudden vision changes, confusion), seek medical help right away.

• Bleeding, such as from cuts that take longer than usual to stop bleeding, nosebleeds, and bruising more often than usual
• Fever
• Muscle pain
• Itching
• Diarrhea
• Stomach pain
• Indigestion 

• Fast heartbeats
• Shortness of breath
• Headache
• Fever
• Weakness
• Feeling tired
• Little or no urination
• Seizure
• Low blood sugar (headache, hunger, sweating, irritability, dizziness, fast heart rate, feeling anxious or shaky)
• Signs of a blood clot such as sudden numbness or weakness, confusion, and problems with vision or speech.

Before taking any drug, changing any diet, or commencing or discontinuing any course of treatment, consult a healthcare provider.

Coadministration of antiplatelet agents increases the risk of bleeding due to an additive effect. Promptly evaluate any signs or symptoms of blood loss if patients are treated concomitantly with other antiplatelet agents.

The acyl--glucuronide metabolite of clopidogrel is a strong inhibitor of CYP2C8. Plavix can increase the systemic exposure to drugs that are primarily cleared by CYP2C8, thereby needing dose adjustment and appropriate monitoring. Avoid concomitant use of repaglinide with Plavix. If concomitant use cannot be avoided, initiate repaglinide at 0.5 mg before each meal and do not exceed a total daily dose of 4 mg. Increased frequency of glucose monitoring may be required during concomitant use.

Instruct patients to get prompt medical attention if they experience symptoms of Thrombotic Thrombocytopenic Purpura TTP that cannot otherwise be explained.

Advise patients to inform healthcare providers that they are taking Plavix before any surgery or dental procedure.

Advise patients not to take omeprazole or esomeprazole while taking Plavix. Dexlansoprazole, lansoprazole, and pantoprazole had less pronounced effects on the antiplatelet activity of Plavix than did omeprazole or esomeprazole.

Plavix is considered a pregnancy Category B drug. Discuss pregnancy with a healthcare provider before using Plavix. If nursing or planning to nurse, it is not known if Plavix passes through breast milk. Therefore, it is recommended not to take Plavix until discussing it with a healthcare provider.

Plavix only works if the body can properly metabolize (process) the drug. Before starting to take this drug, a healthcare provider will order tests to check whether your body can metabolize Plavix.

This is not an exhaustive list of warnings and precautions of Plavix. Consult a healthcare provider for personalized advice and guidance.