What side effects can Clopidogrel have?
Below you will find the most important information about possible known side effects of clopidogrel.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Common side effects:
Bleeding, bleeding, nosebleeds, bruising, bruising, cerebral hemorrhage, indigestion, abdominal pain, diarrhea, bruising on injections or puncturing.
Uncommon side effects:
lack of white blood cells, lack of platelets, lack of immature blood cells, prolonged bleeding time, brain bleeding (some fatal cases), headache, nervous sensation, dizziness, drowsiness, bleeding, nausea and vomiting, Gastritis, flatulence, constipation, gastric and duodenal ulcers, rash, itching, blood in the urine.
Rare side effects:
lack of neutrophils blood cells (too severe), dizziness, bleeding behind the peritoneum.
Very rare and isolated side effects: hypogeal bleeding (thrombotic thrombocytopenic purpura), anemia (aplastic anemia), deficiency of all blood cells, absence of granulocytes, lack of granulocytes, severe platelet deficiency, (acquired) hemophilia, serum sickness , allergic shock, hypersensitivity reactions to ticlopidine or prasugrel, delusions, confusion, taste disturbances, heavy bleeding, bleeding from surgical wounds, blood vessel inflammation, low blood pressure, respiratory bleeding (hemoptysis, pulmonary haemorrhage), bronchospasm, pneumonia (interstitial pneumonia, eosinophilic pneumonia), hemorrhage Gastrointestinal tract and abdominal cavity with fatal outcome, pancreatitis, colitis, oral mucositis, acute liver failure, liver inflammation, liver abnormalities, severe skin reactions (toxic epidermal necrolysis, Stevens-Johnson-Sy nasal erythema multiforme), blood vessel swelling, drug hypersensitivity, drug rash, skin rash, hives, eczema, lichen planus, muscle or bone bleeding, arthritis, joint pain, muscle pain, kidney disease (glomerulonephritis), increase in creatinine in the blood, fever.
When combined with acetylsalicylic acid, mild and heavy bleeding (especially in the gastrointestinal tract) occurs significantly more frequently. Life-threatening or even deadly hemorrhages as well as brain haemorrhages on the other hand do not increase by the combination.
Clopidogrel may cause extensive bruising and bleeding two to three months after initiation of therapy in individual cases. Presumably, this is due to a reduction in the concentration of coagulation factor VIII. If you experience large bruises during treatment with clopidogrel, your doctor should check for blood clotting.
In isolated cases, clopidogrel may cause hemophilia in patients who previously had no coagulation disorder. The coagulation factors VIII or IX are inhibited in their activity, resulting in severe bleeding. In such cases, drug therapy should be stopped immediately and patients should be treated by a specialist.
Negative effects on liver function have been reported with clopidogrel treatment. If signs of liver damage occur during treatment with the active substance (weight gain due to accumulation of water in the abdomen, itching, nausea, confusion or jaundice), a doctor should be contacted immediately.
What interactions does clopidogrel show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
As a precaution, clopidogrel should not be taken with other blood coagulation-modifying agents. These include: warfarin, abciximab, eptifibatide and other glycoprotein IIb / IIIa inhibitors, acetylsalicylic acid, naproxen, heparin, fibrinolytics and non-steroidal anti-inflammatory drugs. Particularly dangerous is the combination with acetylsalicylic acid and vitamin K antagonists (warfarin, dicoumarol).
Proton pump inhibitors, which are used against excess stomach acid, inhibit the conversion of clopidogrel into its active form in the body. Thus, clopidogrel can develop its desired effect only poorly. According to the current state of knowledge, the doctor should avoid the combination of clopidogrel and a proton pump inhibitor. As an alternative to gastric acid blockade, for example, the H2-receptor blocker ranitidine (but not cimetidine!) Serve. If it is still necessary to use a proton pump inhibitor, the doctor should choose pantoprazole.