Clopistad Special Precautions

Clopidogrel prolongs bleeding time.
Use with caution in patients at increased risk of bleeding from trauma, surgery, ulcers, or other pathology, particularly gastrointestinal or intramuscular conditions. If bleeding or hematologic disorders are suspected, promptly consider determining blood cell counts or other appropriate monitoring. Discontinue clopidogrel 5-7 days prior to elective surgery or coronary artery bypass graft (CABG), if antiplatelet effect is undesirable. Drugs (e.g., aspirin, other nonsteroidal anti-inflammatory drugs) that might induce such lesions should be used with caution in patients receiving clopidogrel.
Use with caution because of possibility of bleeding diatheses in patients with severe hepatic disease.
Experience is limited in patients with severe renal impairment (creatinine clearance of 5 - 15 mL/minute); use with caution.
Pharmacogenetics: Based on literature data, patients with genetically reduced CYP2C19 function (intermediate or poor metabolisers) have lower systemic exposure to the active metabolite of clopidogrel and diminished antiplatelet responses, and generally exhibit higher cardiovascular event rates following myocardial infarction than do patients with normal CYP2C19 function.
Effects on ability to drive and use machines: Clopidogrel has no or negligible influence on the ability to drive and use machine.