the most common adverse effects are indigestion , bleeding disorders , rash , diarrhea , and , rarely , taste disorders . here , we report a case of clopidogrel - induced ageusia notified in sfax pharmacovigilance center on march 13 , 2009 . a 46-year - old man was admitted in the department of cardiology in sfax tunisia in january 2009 for coronary artery disease and underwent coronary artery stenting . clopidogrel ( 150 mg / day ) was initiated on january 8 , 2009 , with lysine acetylsalicylate ( one bag / day ) and molsidomine ( 60 mg / day ) . however , the sense of smell was not affected . the ear nose throat ( ent ) examination ruled out abnormality ( dryness , atrophy , or infection ) of buccal mucosa and cranial nerve lesion . it was considered that simvastatin could be responsible for this adverse effect and it was then stopped it is indicated for secondary prevention in patients with atherosclerosis , coronary artery disease , and cerebral event such as transient ischemic attack . the caprie study demonstrated that clopidogrel has a favorable efficacy / safety ratio and provides an additional 8.7% relative - risk reduction for thrombotic events over lysine acetylsalicylate and is safer than ticlopidine . in addition , several other clinical studies have shown that clopidogrel reduces the overall rate of thromboembolic events in patients with recent myocardial infarction , stroke , or peripheral arterial disease compared with aspirin . side effects of new medicines are often not revealed during the initial clinical trials but are discovered when their use becomes a standard of care and , therefore , widespread . indeed , in the present case , an enquiry of pharmacovigilance was done according to french imputation method . besides psychogenic , systemic , oral , and neurological pathologies , medicines are the most common cause of taste disturbance . the fact that a large variety of medications affect the sense of taste is evidence of the complexity of the gustatory systems . the reception , transduction , propagation , and perception of a chemical tasting or odorant require the effective operation of numerous mechanisms . . thus , drug - induced adverse taste effects can reflect the taste of the drug itself , destroy mitosis in a replicating receptor cell , block the apical ion channels on a taste bud as a diuretic , and lead to candidal overgrowth on the tongue surface as immunosuppressants and steroids . these can also inhibit cytochrome p450-dependent enzymes at the level of receptors as an antifungal , disturb neuronal impulse propagation , cause changes in the neurotransmitter function , as well as alter higher order cortical processing of taste - related sensory information , production , and chemical composition of saliva and mucosal elements . the time of appearance of this side effect in the present case was similar to that reported in literature between two to eight weeks . this observation reminds the dose - related mechanism that remit spontaneously after drug discontinuation , albeit sometimes weeks or months after discontinuing a drug . the present case confirms the hypothesis and the suspected causal drug clopidogrel in the genesis of ageusia . although not a life - threatening side effect , loss of taste can produce significant changes in quality of life of a patient . it can lead to loss of appetite , weight , and may require discontinuation of drug administration in already compromised patients .
clopidogrel is prescribed in cardiac and extracardiac vascular diseases . 
 it is generally well tolerated ; however , few cases of taste disorders have been reported . 
 we present a case of clopidogrel - induced ageusia notified in sfax pharmacovigilance center on march 13 , 2009 . 
 a 46-year - old patient developed ageusia with decreased appetite five weeks after starting clopidogrel . 
 other etiologies including ear nose throat ( ent ) examination were ruled out . 
 five months after reduction of clopidogrel dose , ageusia partially decreased . 
 clopidogrel was strongly suspected as a causal drug . according to the french imputation method , score of imputability 
 was considered as plausible ( c2s2 ) i2 . 
 physiopathology of this side effect is not yet understood . 
 however , it seems to be a reversible and dose - related event . 
 although it is not life - threatening , loss of taste can have significant effect on the quality of life of patients .