Cases of thrombocytopenic purpura (usually occurring within the first 2 weeks of therapy) have been reported; urgent plasmapheresis is required.
Use with caution in patients with platelet disorders and/or at increased risk for bleeding (e.g., peptic ulcer disease, trauma, or surgery), severe hepatic and renal impairment.
Consider discontinuing clopidogrel 5 days prior to elective surgery, except in patients with cardiac stents that have not completed their full course of dual antiplatelet therapy. Patient-specific situations need to be discussed with a physician or cardiologist.
Use in Children: Safety and efficacy have not been established in patients younger than 21 years old.
Use in the Elderly: Dosage adjustment based solely on age does not appear to be necessary in geriatric patients.