TTP (very rarely) after short exposure (<2 wk). Blood cell count determination &/or other appropriate testing whenever clinical symptoms suggestive of bleeding arise during course of treatment. Patients who may be at risk of increased bleeding from trauma, surgery or other pathological conditions & in patients receiving treatment w/ ASA, heparin, glycoprotein IIb/IIIa inhibitors or NSAIDs including COX-2 inhibitors, or SSRIs, or other medicinal products associated w/ bleeding risk eg, pentoxifylline. Not recommended w/ concomitant administration of oral anticoagulants since may increase intensity of bleedings. Discontinue 7 days prior to surgery. Inform physicians & dentists that the patient is under treatment before any surgery is scheduled & before any new medicinal product is taken. Prolonged bleeding time; patients who have lesions w/ propensity to bleed (particularly GI & intraocular). Discontinue use in patients w/ confirmed diagnosis of acquired hemophilia. Not recommended during the 1st 7 days after recent/acute ischemic stroke. Discourage concomitant use of strong or moderate CYP2C19 inhibitors. Patients treated concomitantly w/ CYP2C8 substrate medicinal products. Evaluate patients for history of hypersensitivity to thienopyridines (eg, ticlopidine, prasugrel) due to cross-reactivity among thienopyridines. Monitoring for signs of hypersensitivity in patients w/ known allergy to thienopyridines. Contains lactose; not to be taken by patients w/ rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Contains hydrogenated castor oil which may cause stomach upset & diarrhea. Renal & hepatic impairment. Do not use during pregnancy. Do not continue breastfeeding during treatment.
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