This sheet is about exposure to clopidogrel in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is clopidogrel?
Clopidogrel is an antiplatelet medication that helps prevent blood clots. It has been used to help prevent heart attacks and strokes. A brand name for clopidogrel is Plavix®.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
I take clopidogrel. Can it make it harder for me to get pregnant?
Studies have not been done to see if taking clopidogrel can make it harder to get pregnant. In animal studies, clopidogrel did not affect fertility (ability to get pregnant).
Does taking clopidogrel increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if clopidogrel can increase the chance of miscarriage. Studies conducted on animals did not report an increase in miscarriages.
Does taking clopidogrel increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like clopidogrel, might increase the chance of birth defects in a pregnancy.
Information on the use of clopidogrel in pregnancy is limited. In animal studies, clopidogrel did not increase the chance of birth defects. In 17 case reports of women taking clopidogrel during pregnancy, no birth defects were reported in 16 of the babies. A heart defect was reported in 1 baby. A single case report is not enough information to link an exposure to a birth defect. Also, in all of these reports, other medications were also taken during pregnancy. This makes it hard to know if clopidogrel, the combination of medications, or other factors are related to the reported heart defect.
Does taking clopidogrel in pregnancy increase the chance of other pregnancy-related problems?
Studies have not been done to see if clopidogrel can increase the chance for other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).
Taking clopidogrel during labor or delivery may increase the chance of bleeding and hemorrhaging (too much blood loss) in the woman giving birth. There is also an increased chance of spinal hematoma (when blood collects in the spine) when women who take clopidogrel get an epidural (injection of medication into the space around your spinal nerves to provide pain relief (analgesia) or numbness in one area of the body). The product label and professional medical societies, including the American Society of Regional Anesthesia and Pain Medicine and the American Academy of Pain Medicine, have recommended that anyone taking clopidogrel stop taking it 5-7 days before labor, delivery, or getting an epidural.
Does taking clopidogrel in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if clopidogrel can increase the chance of behavior or learning issues for the child.
Breastfeeding while taking clopidogrel:
In two women taking clopidogrel, it was found that clopidogrel and its metabolites appeared in breast milk in minimal quantities, below the limit of detection. No side effects have been reported in a small number of infants exposed to clopidogrel through breast milk. If you suspect the baby has any symptoms (such as bruising or bleeding), contact the child’s healthcare provider.
There is a theoretical (not proven) concern that if a baby is exposed to clopidogrel through breast milk, the baby’s platelets may not work correctly. This has not been noted in the reports on infants exposed to clopidogrel through breastmilk.
If a man takes clopidogrel, could it affect fertility or increase the chance of birth defects?
Studies have not been done in humans to see if clopidogrel could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. In animal studies, there were no reported effects on fertility. In general, exposures that men have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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