76% of the dose, and a recall that goes all the way to the patient
What happened
On 26 October 2026, the Medicines and Healthcare products Regulatory Agency (MHRA) issued a recall for a liquid version of clopidogrel, a medicine that helps stop dangerous blood clots forming. The company behind it, Xeal Pharma, told the MHRA that every strength of its Clopidogrel Oral Solution and Clopidogrel Oral Suspension contains less clopidogrel than the label says. The cause was a formulation error - a mistake in the recipe. The affected batches contain 76% of the amount of clopidogrel they should contain. That is roughly a quarter less than the dose written on the bottle. Every batch made before the alert is affected. The alert reference is EL(26)A/43. This is a Class 2 recall at patient, pharmacy and wholesaler level. The words "patient level" are the important part. Most medicine recalls stop at the pharmacy shelf. This one does not. Pharmacies have been asked to find the actual people who took the medicine home, and ring them. The MHRA has told pharmacists to stop supplying the affected batches immediately, put any remaining stock to one side, and send it back to their supplier. They must then identify and immediately contact everyone who was given these batches, and ask whether they still have any at home. If a pharmacy cannot tell which batch went to which person, the instruction is wider: contact everyone who was dispensed the product from 20 July 2026 onwards. The full list of affected batch numbers is published in Annex 1 of the alert on GOV.UK.
Why this matters
Clopidogrel is not a medicine people take for a symptom they can feel. It is an antiplatelet. It stops platelets, a type of blood cell, from sticking together and forming a dangerous clot. The NHS says people are usually prescribed it if they have had, or are at higher risk of, a heart attack, unstable angina, a stroke or a "mini-stroke" (a transient ischaemic attack, or TIA), peripheral arterial disease or atrial fibrillation. It is also given to people who have had an operation on their heart or blood vessels, such as having a stent fitted. So the people affected here are, by definition, people whose doctors judged them to be at real risk of a stroke or a heart attack. For that group, an under-strength dose is not a minor labelling slip. It is less protection than their prescriber intended. There is a second reason this matters, and it is easy to miss. Clopidogrel normally comes as tablets. The MHRA alert points out that there is no licensed clopidogrel liquid available in the UK at all, and lists the recalled product as an unlicensed medicine. Liquid versions exist because some people simply cannot swallow tablets. That includes many older people, people who are fed through a tube, and people with conditions that make swallowing difficult or unsafe. That makes the fix harder than handing over a different bottle. The MHRA says affected patients may need their dose corrected, a different licensed form of the medicine, or a different treatment altogether. Some may need monitoring, and more than one clinician may need to be involved.
What the evidence actually says
It is worth being precise about the level of risk here, because the alert itself is careful about it, and the headline number sounds worse than the evidence supports. Xeal Pharma carried out a risk assessment. Based on it, the MHRA alert says patient harm is not anticipated in people taking the affected product for long-term preventative treatment. The alert also states plainly that no reports of patient harm have been received about this issue, and that the recall is being carried out "out of an abundance of caution". What the alert does say happened is simpler: patients did not receive the full, prescribed dose. The alert is far more emphatic about a different danger - and it is the opposite of the one people might jump to. Both the advice for healthcare professionals and the advice for patients warn that suddenly stopping clopidogrel may cause serious thrombotic events, meaning dangerous blood clots. The NHS says the same thing in its own words: "Do not stop taking clopidogrel without talking to your doctor. If you stop taking it, you may be at increased risk of serious problems like heart attacks or strokes." So the evidence points in one clear direction. The under-dosing is a real problem and it needs fixing. But it has not been linked to any reported harm, while stopping the medicine in response to the news is the thing most likely to cause harm. That is why the instruction is to keep taking it as advised until a replacement has been arranged.
Qurexa perspective
We deliver prescriptions and help people keep on top of taking their medicines, so this is exactly the kind of alert we watch for. The honest point worth adding is about who liquid medicines are for. A liquid version of a heart or stroke medicine is usually in someone's home because tablets are not an option for them. In practice that often means an older person, someone recovering from a stroke, or someone being looked after by a family member or a paid carer. Those are exactly the households where a recall notice is easiest to miss, and where "ring your pharmacy" is harder than it sounds. If you care for someone in that position, the most useful thing you can do today is check the bottle yourself rather than wait for the phone to go. Pharmacies are working through their dispensing records, but records are not perfect - which is precisely why the MHRA added the catch-all instruction to contact everyone supplied since 20 July. Whoever dispenses or delivers your medicines, the pharmacy named on the label is the right place to ask.
Practical advice
If you or someone you care for takes clopidogrel as a liquid: Do not stop taking it. This is the single most important point on this page. Keep taking it exactly as you were told until a healthcare professional arranges something different. Check the label and the box. You are looking for Clopidogrel Oral Solution or Clopidogrel Oral Suspension from Xeal Pharma. Every strength is affected. Clopidogrel tablets are not affected by this recall. Expect a call, but do not only wait for one. Your GP, specialist or pharmacist should be in touch. If you think you have the product and nobody has contacted you, ring the pharmacy named on the label. Do not try to correct the dose yourself. Taking extra to make up the shortfall is not the answer, and the NHS warns against doubling up on clopidogrel. Only your prescriber should change your dose. Return it only once you have a replacement. The alert is explicit about the order: get the alternative first, then take the old product back to your pharmacy as part of the recall. Report any side effects. Suspected reactions to any medicine can be reported through the MHRA's Yellow Card scheme. If you feel unwell or have questions about your medication, seek medical attention. If you are worried, you can contact your healthcare professional directly - but keep taking your medicine while you do. If you take clopidogrel as tablets, this recall does not apply to you, and there is nothing you need to do.
What to know
The headline figure is 76%. The affected clopidogrel liquids contain about three-quarters of the dose printed on the label, because of a mistake in how they were made. Every batch made before 26 October 2026 is affected, in every strength. The recall reaches patient level. That is why pharmacies are phoning people directly, and why, where batch records are incomplete, they have been told to contact everyone supplied since 20 July 2026. The reassuring part is genuine: no harm has been reported, and the company's risk assessment did not expect harm in people taking the product as long-term prevention. The warning is equally genuine, and it runs the other way - stopping clopidogrel suddenly can cause dangerous clots. Anyone who wants the official detail, including the full list of affected batch numbers, can read the alert on GOV.UK. Enquiries about the product itself go to Xeal Pharma at [email protected] or 0121 3090067. Sources: Medicines and Healthcare products Regulatory Agency, "Class 2 Medicines Recall: Xeal Pharma, Clopidogrel Oral Liquids (all strengths), EL(26)A/43", GOV.UK, 26 October 2026, https://www.gov.uk/drug-device-alerts/class-2-medicines-recall-xeal-pharma-clopidogrel-oral-liquids-all-strengths-el-26-a-slash-43 ; NHS, "About clopidogrel", nhs.uk, last reviewed 12 March 2025, https://www.nhs.uk/medicines/clopidogrel/about-clopidogrel/ ; NHS, "How and when to take clopidogrel", nhs.uk, last reviewed 12 March 2025, https://www.nhs.uk/medicines/clopidogrel/how-and-when-to-take-clopidogrel/ This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional. If you take clopidogrel, do not stop it or change your dose because of anything you have read here - speak to your GP or pharmacist first.
Related articles
48 hours from 25 November, and the first consultant strike since 2023
On Monday 26 October 2026, the British Medical Association (BMA) announced that consultants in England will go on strike in November. Consultants are the most…
1% against 3.3%, and the bleeding figure nobody should skip
Researchers at Monash University in Australia have reported that low-dose aspirin was linked to a much lower risk of dementia — but only in one particular genet…
830 children, a small sponge, and no drill
A large clinical trial has confirmed that a liquid painted onto a decayed baby tooth can stop the decay getting worse, with no drilling, no injection and no sed…