Norplat/Norplat-S Special Precautions

General: Clopidogrel should be used with caution in patients who may be at risk of increased bleeding from trauma, surgery or other pathological conditions.
If a patient is to undergo elective surgery, consideration should be given to stopping clopidogrel 5 days before surgery.
Clopidogrel should be used with caution in patients who have lesions with a propensity to bleed (eg, ulcers). Drugs that might induce such lesions should be used with caution in patients taking clopidogrel.
Hematological: Full blood count should be performed before starting treatment and every 2 weeks during the first 3 months of therapy. If clopidogrel is discontinued during this period, a full blood count should be performed within 2 weeks of stopping treatment.
Norplat: Clopidogrel should not be administered to patients with hematopoietic disorders eg, neutropenia or thrombocytopenia, hemorrhagic diathesis or other hemorrhagic disorders associated with a prolonged bleeding time.
Norplat-S: Aspirin should be used with caution in children or teenagers with chickenpox, influenza or fever.
Patients allergic to ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs). Patients with chronic or recurrent stomach or duodenal ulcers or digestive hemorrhages; severe renal disease; suffering from allergic diseases eg, asthma or urticaria and gout.
Patients with Hepatic Impairment: Experience is limited in patients with severe hepatic disease, who may have bleeding diatheses. Norplat/Norplat-S should be used with caution in such patients.
Patients with Renal Impairment: Experience is limited in patients with severe renal impairment. Norplat/Norplat-S should be used with caution in such patients.
Use in Pregnancy & Lactation: Norplat: Clopidogrel has not been studied in pregnant women. It should be used during pregnancy only if clearly needed.
It is not known if clopidogrel is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when clopidogrel is given to nursing mother.
Use in Children: Norplat: Safety and effectiveness in the population have not been established.