Due to opening of the thiophene ring, the chemical structure of the active metabolite has three sites that are stereochemically relevant, making a total of eight possible isomers. Only one of the eight structures is an active antiplatelet drug. This has the following configuration: Z configuration at the C3—C16 double bond, the original S configuration at C7, [30] and, although the stereocentre at C4 cannot be directly determined, as the thiol group is too reactive, work with the active metabolite of the related drug prasugrel suggests the R-configuration of the C4 group is critical for P2Y12 and platelet-inhibitory activity.
Patients with a variant allele of CYP2C19 are 1. Administration of clopidogrel bisulfate with meals did not significantly modify the bioavailability of clopidogrel as assessed by the pharmacokinetics of the main circulating metabolite. In vitro and in vivo, clopidogrel undergoes rapid hydrolysis into its carboxylic acid derivative. During pregnancy , this medication should be used only when clearly needed.
Discuss the risks and benefits with your doctor. It is unknown if this drug passes into breast milk. Consult your doctor before breast -feeding. Interactions See also How to Use section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
A product that may interact with this drug is: If you are currently taking aspirin , consult your doctor promptly and ask whether to continue or stop taking it with this medication for your specific condition aspirin and clopidogrel may be used in combination after a coronary stent procedure, or for some heart conditions.
If you are not currently taking aspirin, consult your doctor before starting it for any medical condition. Other medications can affect the removal of clopidogrel from your body, which may affect how clopidogrel works. Promptly ask your doctor or pharmacist for more details.
Clopidogrel can slow down the removal of other drugs from your body, which may affect how they work. Examples of affected drugs include dasabuvir, repaglinide , among others. Ask your pharmacist about using these products safely. Should I avoid certain foods while taking Clopidogrel? Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Otherwise, call a poison control center right away. US residents can call their local poison control center at Canada residents can call a provincial poison control center.
Notes Do not share this medication with others. Consult your doctor for more details. Missed Dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose. There may be new information. This Medication Guide does not take the place of talking with your doctor about your medical condition or your treatment. What is the most important information I should know about Plavix?
Plavix may not work as well in people who: Your doctor may do genetic tests to make sure Plavix is right for you. Your doctor may change the medicine you take for stomach acid problems while you take Plavix. Plavix can cause bleeding which can be serious and can sometimes lead to death. Plavix is a blood thinner medicine that lowers the chance of blood clots forming in your body. While you take Plavix: People who stop taking Plavix too soon have a higher risk of having a heart attack or dying.
If you must stop Plavix because of bleeding, your risk of a heart attack may be higher. Plavix is a prescription medicine used to treat people who have any of the following: Platelets are blood cells that help your blood clot normally.
Plavix helps to prevent platelets from sticking together and forming a clot that can block an artery. It is not known if Plavix is safe and effective in children. Who should not take Plavix? Do not take Plavix if you:
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