Norplat/Norplat-S Drug Interactions

Warfarin: Because of the increased risk of bleeding, the concomitant administration of warfarin with clopidogrel should be undertaken with caution.
Drugs Metabolized by Cytochrome P-450: At high concentrations in vitro, clopidogrel inhibits P-450 (2C9). Accordingly, it may interfere with the metabolism of phenytoin, tamoxifen, tolbutamide, warfarin, torsemide, fluvastatin and many NSAIDs, but there are no data with which to predict the magnitude of these interactions. Caution should be used when any of these drugs is co-administered with clopidogrel.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Concomitant administration of Norplat-S may be associated with increased occult gastrointestinal blood loss. Norplat-S and NSAIDs should be co-administered with caution.
Norplat: Aspirin: A pharmacodynamic interaction between clopidogrel and aspirin is possible, leading to increased risk of bleeding. Therefore, concomitant use should be undertaken with caution. However, clopidogrel and aspirin have been administered together for up to 1 year.
Heparin: A pharmacodynamic interaction between clopidogrel and heparin is possible, leading to increased risk of bleeding. Therefore, concomitant use should be undertaken with caution.
Norplat-S: Anticoagulants, Coumarin, Heparin or Thrombolytic Agents: Norplat-S may cause hypoprothrombinemia leading to increased anticoagulation and risk of bleeding when given concomitantly with anticoagulants, coumarin, heparin or thrombolytic agents.
Methotrexate: Aspirin may decrease renal clearance of methotrexate leading to toxic methotrexate plasma concentrations. If they are used concurrently, methotrexate dosage should be decreased.
Antidiabetic Agents: Antidiabetic agents potentiate the effect of salicylates.
Uricosuric Agents: Although salicylates in larger doses are uricosuric agents, smaller amounts may decrease the uricosuric effects of probenecid, sulfinpyrazone and phenylbutazone.
Antacids: The effects of acetylsalicylic acid may be decreased by concurrent use of antacids.