Plogrel Special Precautions

Cases of thrombocytopenic purpura (usually occurring within the first 2 weeks of therapy) have been reported. Urgent plasmapheresis is required.
Patients with platelet disorders and/or at increased risk for bleeding (eg, 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 pregnancy & lactation: Pregnancy category B. Teratogenic effects were not observed in animal studies. There are, however, no adequate and well controlled studies in pregnant women. Use in pregnancy only if clearly needed.
Clopidogrel is distributed into milk in rats. It is not known whether the drug is distributed into milk in humans. Discontinue breastfeeding or Plogrel because of potential adverse effects in infants.
Use in children: Safety and efficacy have not been established in patients <21 years.
Use in the elderly: Dosage adjustment based solely on age does not appear to be necessary in geriatric patients.