Trademarks are the property of their respective owners. Other bleeding events that were reported more frequently in the Clopidogrel group were epistaxis and hematoma.
Bleeding of all severities was more common in the subjects randomized to Clopidogrel.
In a study in healthy male subjects when Clopidogrel 75 mg per day was given with a standard breakfast, mean inhibition of ADP-induced platelet aggregation was reduced by less than 9%. See "What is the most important information I should know about Clopidogrel tablets?". In vitro studies have shown that the glucuronide metabolite of Clopidogrel is a strong inhibitor of CYP2C8. Because these reactions are reported voluntarily from a population of an unknown size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Clopidogrel can be administered with or without food. Inhibition of platelet aggregation by Clopidogrel is achieved through an active metabolite. Figure 7: Fatal or Nonfatal Vascular Events in the CAPRIE Study. lopidogrel tablets and all medicines out of the reach of children. Clopidogrel is extensively metabolized by two main metabolic pathways: one mediated by esterases and leading to hydrolysis into an inactive carboxylic acid derivative (85% of circulating metabolites) and one mediated by multiple cytochrome P450 enzymes. Your doctor may tell you to stop taking Clopidogrel tablets at least 5 days before you have surgery to avoid excessive bleeding during surgery. Concomitant use of drugs that inhibit the activity of this enzyme results in reduced plasma concentrations of the active metabolite of Clopidogrel and a reduction in platelet inhibition [see Warnings and Precautions (5.1)]. 2017 Jan 29;18(2):269. doi: 10.3390/ijms18020269. Disease-associated maternal and/or embryo/fetal risk. A decision should be made with your healthcare provider to avoid or discontinue breastfeeding when continuing Clopidogrel tablets is needed. Platelet aggregation and bleeding time gradually return to baseline values after treatment is discontinued, generally in about 5 days.
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