Drug interactions
Clopidogrel + Diclofenac
Severity: Major
Clopidogrel and Diclofenac: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs impair hemostasis, and NSAIDs also damage the gastroduodenal mucosa. Concurrent use substantially increases the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Clopidogrel and Diclofenac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clopidogrel belongs to Cardiovascular; Diclofenac belongs to Musculoskeletal.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus COX-1 inhibition) combined with NSAID-induced mucosal injury.
What to do
Avoid the combination if possible and use paracetamol or another alternative for pain; if unavoidable, add a proton pump inhibitor (preferably one that does not inhibit CYP2C19 strongly, such as pantoprazole) and monitor for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Clopidogrel and Diclofenac, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
Other interactions of Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Diclofenac?
MediHelp rates the interaction as major. Clopidogrel and Diclofenac can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs impair hemostasis, and NSAIDs also damage the gastroduodenal mucosa. Concurrent use substantially increases the risk of gastrointestinal and other bleeding.
How serious is the interaction between Clopidogrel and Diclofenac?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible and use paracetamol or another alternative for pain; if unavoidable, add a proton pump inhibitor (preferably one that does not inhibit CYP2C19 strongly, such as pantoprazole) and monitor for bleeding.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
