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Table 1: Reports of hematolgical reactions associated with clopidogrel submitted to the CADRMP
between Oct. 31, 1998, and Aug. 31, 2000
Case	Age/sex	Reported reactions*	Time to onset	Outcome†	Medical history/ comments	Cosuspect‡and concomitant drugs
1	73/M	Disseminated intravascular coagulation (DIC), hematoma	48 h	Recovered	Hypertension, hypercholesterolemia. Carotid endarterectomy complicated by stroke before clopidogrel therapy. Hematomas considered symptom of DIC	Concomitant: bisacodyl, Colace, Losec, metoprolol, Monopril

2	74/M	Pancytopenia, myeloproliferative disorder	4 d	Not yet recovered	Diabetes mellitus, congestive heart failure. Treated with clopidogrel after angioplasty with stent. Pancytopenia may have predated clopidogrel therapy	Concomitant: furosemide, glyburide, lisinopril, metformin

3	94/M	Thrombocytopenia, anemia, leucopenia, purpura	31 d	Recovered	Hypertension, coronary artery disease, osteoarthritis, myocardial infarction, benign bladder tumour	Concomitant: ASA, diltiazem, heparin, metoprolol, Monopril, nifedipine, Nitro-Dur, ranitidine

4	64/M	Agranulocytosis	19 d	Recovered	Neutropenia associated with Ticlid 1 mo before use of clopidogrel. Dialysis for unspecified reason	Concomitant: acebutolol, acetaminophen, ASA, alprazolam, cefazolin, erythropoietin, folic acid, furosemide, hydroxyzine, iron dextran, loperamide, losartan, metoclopramide, morphine, nitroglycerin, oxazepam, sertraline, Ticlid, zopiclone others§

5	73/F	Agranulocytosis	41 d	Recovered	Received clopidogrel after angioplasty	Concomitant: amlodipine, ASA enteric coated, calcium, Lipitor, vitamin D

6	NA/M	Granulocytopenia	4 mo	Not yet recovered	Positive dechallenge	NA

7	NA/M	Granulocytopenia	NA	Not yet recovered	Positive dechallenge	NA

8	71/M	Thrombocytopenia, myocardial infarction, coronary thrombosis	7 d	Died; drug may have been contributory	Smoking, hyperlipidemia, myocardial infarction, hypertension. Current condition: myocardial infarction attributed to coronary thrombosis that was attributed to stent. Thrombocytopenia likely not due to clopidogrel because drug was started after thrombocytopenic event.	Cosuspect: heparin, Reopro, rt-PA. Concomitant: ASA, metoprolol, nitroglycerin, Vasotec

9	68/F	Thrombocytopenia, acute renal failure, cardiac failure	NA	NA	Congestive heart failure, diabetes mellitus. PTCA with multiple stent placement	Cosuspect: heparin, Reopro Concomitant: ASA, folic acid, glyburide, Lanoxin, Lasix, metformin, nitroglycerin, quinapril, vitamins (B6, B12, E)

10	69/M	Thrombocytopenia, injection site reaction, erythematous rash, flushing	NA	Not yet recovered	PTCA	Cosuspect: Reopro Concomitant: ASA, metoprolol, nitroglycerin

11	NA/F	Thrombocytopenia	4 h	Recovered	Myocardial infarction. PTCA	Cosuspect: heparin, Reopro Concomitant: ASA

12	73/F	Thrombocytopenia	13 d	Recovered	Angina, hypertension, coronary arteriosclerosis	Cosuspect: heparin Concomitant: Ceftin, Entrophen, Lopresor, nitroglycerin

13	60/M	Thrombocytopenia	10-12 d	Not yet recovered	Coronary artery disease, hypertension, gout, hypercholesterolemia. Received clopidogrel after stent	Concomitant: ASA enteric coated, lisinopril, Losec, nifedipine XL, nitroglycerine, Nitrong SR, Pravachol

14	NA/F	Thrombocytopenia	6 d	Recovered	Rheumatoid arthritis. Admitted for non-Q-wave myocardial infarction. Received clopidogrel after stent	Cosuspect: Reopro Concomitant: ASA, heparin, methotrexate

15	66/M	Thrombocytopenia	NA	Not yet recovered	Old myocardial infarction, CABG (x 2), hypertension, hypercholesterolemia. Acute myocardial infarction and PTCA with stent	Cosuspect: heparin, Reopro Concomitant: ASA enteric coated, digoxin, ducosate, furosemide, levothyroxin, lisinopril, metoprolol, nitroglycerin, simvastatin, spironolactone

16	69/M	Thrombocytopenia	NA	Not yet recovered	NA	Cosuspect: Epival Concomitant: atorvastatin, enalapril, metoprolol, ranitidine

17	60/M	Thrombocytopenia, myocardial infarction	1 d thrombo- cytopenia; 7 d myocardial infarction	Recovered	Stable angina. No history of myocardial infarction. PTCA. Negative rechallenge with clopidogrel	Cosuspect: heparin, Reopro

Note: CADRMP = Canadian Adverse Drug Reaction Monitoring Programme, NA = not available,
PTCA = percutaneous transluminal coronary angioplasty, CABG = coronary artery bypass grafting.
* Based on the "preferred term" of the World Health Organization Adverse Reaction Dictionary (WHOART).
† At the time of reporting.
‡Drugs suspected by the reporter in addition to clopidogrel.
§ Other drugs were calcium carbonate, ducosate, lactulose, and vitamins B6, B12, B complex and D.