NHS alert as clopidogrel could cause four ‘common’ side effects

This drug is prescribed to millions of Brits to help prevent blood clots forming

Brits taking a widely prescribed medication have been alerted to four possible adverse reactions. The NHS states these symptoms occur in more than one in every 100 patients.

The health service provides information on its website regarding clopidogrel, an antiplatelet medication. Also marketed under the brand names Grepid and Plavix, it works by preventing platelets from clumping together and creating potentially harmful blood clots.

Doctors typically prescribe this to patients at elevated risk of clot formation to help prevent heart attacks, strokes, or other severe cardiovascular complications. Nevertheless, like all medicines, it carries the possibility of certain adverse reactions.

The NHS states: “Like all medicines, clopidogrel can cause side effects, although not everyone gets them. These common side effects of clopidogrel happen in more than 1 in 100 people.”

They include:

• Bleeding more easily than normal
• Diarrhoea
• Stomach pain
• Indigestion or heartburn

The guidance adds: “Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.”

Severe adverse reactions

Severe adverse reactions are uncommon, occurring in fewer than one in 1,000 patients. Immediate medical attention should be sought by calling a doctor or dialling 111 if:

• There’s blood in your urine
• There’s blood in your poo, or you have black poo that looks like tar
• The whites of your eyes turn yellow, or your skin turns yellow
• You feel very tired or have signs of infection, such as a high temperature or sore throat

The NHS advises that you should “go to A&E now” if:

• You’re coughing up blood
• You’re vomiting blood, or there’s something that looks like coffee grounds in your vomit
• You have a nosebleed that you cannot stop and lasts longer than 10 to 15 minutes

Who cannot take clopidogrel

Clopidogrel is not suitable for some people. To make sure it’s safe for you, the NHS says you should tell your doctor if you:

• Have ever had an allergic reaction to clopidogrel or any other medicine
• Have ever had a stomach ulcer
• Have recently had surgery or a serious injury
• Have had bleeding in your brain (a brain haemorrhage)
• Have a bleeding disorder, such as haemophilia
• Have liver or kidney problems
• Are trying to get pregnant, already pregnant or breastfeeding

Taking it with other medications

Some medicines affect the way clopidogrel works. The NHS says you should tell your doctor if you’re taking any other medicines, including:

• Other medications to prevent blood clots, such as low-dose aspirin, warfarin, rivaroxaban, apixaban, edoxaban, dabigatran, dipyridamole, ticagrelor or prasugrel
• Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen
• Antidepressants known as selective serotonin reuptake inhibitors (SSRIs), for instance, citalopram
• Omeprazole or esomeprazole, used for indigestion and heartburn
• Rosuvastatin, a medication for high cholesterol
• Rifampicin, an antibiotic
• Medications to manage epilepsy, such as carbamazepine
• Medications to treat HIV, such as efavirenz
• Medications to manage type 2 diabetes, such as pioglitazone or repaglinide

The NHS further states: “These are not all the medicines that may cause problems if you take them with clopidogrel. For a full list, see the leaflet inside your medicine packet.”