Clopidogrel is used to lower your risk of having a stroke, blood clot, or serious heart problem after you’ve had a heart attack, severe chest pain (angina), or circulation problems.

Clopidogrel may also be used for purposes not listed in this medication guide.

Clopidogrel side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Also call your doctor at once if you have:

• nosebleeds, pale skin, easy bruising, purple spots under your skin or in your mouth;
• jaundice (yellowing of your skin or eyes);
• fast heartbeats, shortness of breath;
• headache, fever, weakness, feeling tired;
• little or no urination;
• a seizure;
• low blood sugar–headache, hunger, sweating, irritability, dizziness, fast heart rate, and feeling anxious or shaky; or
• signs of a blood clot–sudden numbness or weakness, confusion, problems with vision or speech.

Common side effects of clopidogrel may include:

• bleeding.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not use clopidogrel if you have any active bleeding such as a stomach ulcer or bleeding in the brain.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping clopidogrel may increase your risk of a heart attack or stroke.

Before taking this medicine

You should not use clopidogrel if you are allergic to it, or if you have:

• any active bleeding; or
• a stomach ulcer or bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• an ulcer in your stomach or intestines; or
• a bleeding disorder or blood clotting disorder.

Clopidogrel may not work as well if you have certain genetic factors that affect the breakdown of this medicine in your body. Your doctor may perform a blood test to make sure clopidogrel is right for you.

This medicine is not expected to harm an unborn baby. However, taking clopidogrel within 1 week before childbirth can cause bleeding in the mother. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using this medicine.

How should I take clopidogrel?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use these medicines exactly as directed.

Clopidogrel can be taken with or without food.

Clopidogrel is sometimes taken together with aspirin. Take aspirin only if your doctor tells you to.

Clopidogrel keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

You may need to stop using clopidogrel for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking clopidogrel.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Store at room temperature away from moisture and heat.

Clopidogrel dosing information

Usual Adult Dose for Acute Coronary Syndrome:

Unstable Angina (UA)/Non-ST-Elevation Myocardial Infarction (NSTEMI):
-Loading dose: 300 mg orally once
-Maintenance dose: 75 mg orally once a day
-Duration of therapy: Optimal duration unknown.

ST-Elevation Myocardial Infarction (STEMI):
-Loading dose: 300 mg orally once (OPTIONAL)
-Maintenance dose: 75 mg orally once a day, with or without thrombolytics
-Duration of therapy: Optimal duration unknown.

Comments:
-Administer this drug in combination with aspirin 75 mg to 325 mg orally once a day.
-The benefit of this drug for patients who undergo primary percutaneous coronary intervention is unknown.

Uses: Prevention of atherothrombotic events in patients with non-ST-segment elevation acute coronary syndrome (UA, NSTEMI, those who are to be managed medically, those who are to be managed with coronary revascularization) and STEMI.

Usual Adult Dose for Ischemic Stroke:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Myocardial Infarction:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Peripheral Arterial Disease:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . Overdose can cause excessive bleeding.

What should I avoid while taking clopidogrel?

Avoid alcohol. It can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

If you also take aspirin: Ask a doctor or pharmacist before using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking these products together can increase your risk of bleeding.

What other drugs will affect clopidogrel?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

• a stomach acid reducer such as omeprazole, Nexium, or Prilosec;
• an antidepressant such as citalopram, fluoxetine, sertraline, Cymbalta, Effexor, Lexapro, Pristiq, or Prozac;
• rifampin;
• a blood thinner–warfarin, Coumadin, Jantoven; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Brilinta prevents platelets in your blood from sticking together to form an unwanted blood clot that could block an artery.

Brilinta is used to lower your risk of heart attack, stroke, or death due to a blocked artery or a prior heart attack.

Brilinta is also used to lower your risk of blood clots if you have coronary artery disease (decreased blood flow to the heart) and have been treated with stents to open clogged arteries.

Brilinta is also used to lower your risk of a first heart attack or stroke if you have decreased blood flow to the heart.

Brilinta is also used to lower the risk of stroke and death in adults with a blockage or decreased blood flow in an artery that supplies blood to the brain.

This medicine is usually given together with low-dose aspirin. Carefully follow your doctor’s dosing instructions. Using too much aspirin can make ticagrelor less effective.

Warnings

You should not use Brilinta if you have any active bleeding (including a bleeding stomach ulcer), or a history of bleeding in the brain. Do not use this medicine just before heart bypass surgery (coronary artery bypass graft, or CABG).

You may need to stop using this medicine for a short time before having surgery or dental work, to prevent excessive bleeding. Do not stop taking Brilinta without first talking to your doctor, even if you have signs of bleeding. Stopping this medicine may increase your risk of a heart attack or stroke.

Brilinta may cause you to bleed more easily, which can be severe or life-threatening. Avoid activities that may increase your risk of bleeding or injury.

Call your doctor or seek emergency medical attention if you have bleeding that will not stop. You may also have bleeding on the inside of your body, such as in your stomach or intestines. Call your doctor at once if you have black or bloody stools, red or pink urine, or if you cough up blood or vomit that looks like coffee grounds. These could be signs of internal bleeding.

Many drugs (including some over-the-counter medicines and herbal products) can cause serious medical problems if you take them with Brilinta. It is very important to tell your doctor about all medicines you have recently used.

Before taking this medicine

You should not use Brilinta if you are allergic to ticagrelor, or if you have:

• any active bleeding; or
• a history of bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• a stroke;
• heart problems;
• high cholesterol;
• bleeding problems;
• a stomach ulcer or colon polyps;
• liver disease; or
• kidney disease;
• asthma, COPD (chronic obstructive pulmonary disorder) or other breathing problems;
• recent surgery or serious injuries; or
• if you are planning to have surgery or a dental procedure; or

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether Brilinta passes into breastmilk. Talk to your doctor before using Brilinta if you are breastfeeding.

How should I take Brilinta?

Take Brilinta exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Brilinta is taken together with aspirin. Use these medicines exactly as directed.

Do not take more aspirin than your doctor has prescribed. Taking too much aspirin can make Brilinta less effective.

Take this medicine at the same time each day, with or without food.

If you cannot swallow a tablet whole, crush the pill and mix it with water. Stir and drink this mixture right away. Add more water to the glass, stir, and drink right away.

Brilinta keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

To prevent excessive bleeding, you may need to stop using Brilinta for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking ticagrelor.

Do not stop taking Brilinta without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Ticagrelor may affect medical testing for platelets in your blood and you may have false results. Tell the laboratory staff that you use Brilinta.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Acute Coronary Syndrome:

Following an acute coronary syndrome (ACS) event:

Loading dose: 180 mg orally once
Maintenance dose: 90 mg orally twice a day for 1 year
Maintenance dose after 1 year: 60 mg orally twice a day

Comments:
-This drug should be taken in conjunction with a daily maintenance dose of aspirin 75 to 100 mg orally once a day.
-For at least the first 12 months following ACS, this drug is superior to clopidogrel.

Uses:
-To reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction.
-To reduce the rate of stent thrombosis in patients who have been stented for treatment of ACS.

Usual Adult Dose for Prevention of Atherothrombotic Events:

Following an acute coronary syndrome (ACS) event:

Loading dose: 180 mg orally once
Maintenance dose: 90 mg orally twice a day for 1 year
Maintenance dose after 1 year: 60 mg orally twice a day

Comments:
-This drug should be taken in conjunction with a daily maintenance dose of aspirin 75 to 100 mg orally once a day.
-For at least the first 12 months following ACS, this drug is superior to clopidogrel.

Uses:
-To reduce the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome (ACS) or a history of myocardial infarction.
-To reduce the rate of stent thrombosis in patients who have been stented for treatment of ACS.

Usual Adult Dose for Thromboembolic Stroke Prophylaxis:

60 mg orally twice a day

Use: To reduce the risk of a first myocardial infarction (MI) or stroke in patients with coronary artery disease (CAD) at high risk for such events; while use is not limited to this setting, efficacy of this drug was established in a population with type 2 diabetes mellitus (T2DM).

Usual Adult Dose for Coronary Artery Disease:

60 mg orally twice a day

Use: To reduce the risk of a first myocardial infarction (MI) or stroke in patients with coronary artery disease (CAD) at high risk for such events; while use is not limited to this setting, efficacy of this drug was established in a population with type 2 diabetes mellitus (T2DM).

Usual Adult Dose for Myocardial Infarction — Prophylaxis:

60 mg orally twice a day

Use: To reduce the risk of a first myocardial infarction (MI) or stroke in patients with coronary artery disease (CAD) at high risk for such events; while use is not limited to this setting, efficacy of this drug was established in a population with type 2 diabetes mellitus (T2DM).

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . Overdose can cause excessive bleeding.

What to avoid

Drinking alcohol while taking aspirin can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

While taking Brilinta with aspirin, avoid using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking certain products together can cause you to get too much aspirin which can increase your risk of bleeding.

Brilinta side effects

Get emergency medical help if you have signs of an allergic reaction to Brilinta: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• chest pain;
• fainting or dizzy spells;
• nosebleeds, or any bleeding that will not stop;
• shortness of breath even with mild exertion or while lying down;
• easy bruising, unusual bleeding, purple or red spots under your skin;
• red, pink, or brown urine;
• black, bloody, or tarry stools; or
• coughing up blood or vomit that looks like coffee grounds.

Common Brilinta side effects may include:

• bleeding; or
• shortness of breath.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect Brilinta?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can interact with Brilinta, especially:

• antifungal medicine (including ketoconazole, itraconozole, voriconazole, and others);
• antibiotic medication (including clarithromycin);
• antiviral medicine to treat HIV or AIDS;
• other blood thinners;
• cholesterol medication (including simvastatin or lovastatin);
• heart or blood pressure medication;
• opioid medication;
• seizure medicine; or
• tuberculosis medicine (especially rifampin).