Plavix, Plagerine — Used for Heart Attack, Stroke Risk Reduction, Peripheral Artery Disease
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Written by R. Author | Reviewed by Uche Ruth
Updated on June 25, 2024
Overview
Clopidogrel (also known by its brand name, Plavix) is a medication that's used to prevent heart attack and stroke in certain people who are at higher risk for those events. It comes as a tablet taken by mouth once per day and is also available as a generic medication. Since it's a blood thinner, possible side effects include bleeding and bruising, especially if you take medications that interact with clopidogrel (Plavix) like certain antidepressants, anticoagulants, or non-steroidal anti-inflammatory drugs (NSAIDs).
Clopidogrel (Plavix) is a P2Y12 inhibitor, which is a type of antiplatelet medication. It works by preventing platelets from clumping up together and forming blood clots in your heart or brain. This lowers your risk for a heart attack or stroke.
Pros and cons of Clopidogrel (Plavix)pros and consPharmacist tips for Clopidogrel (Plavix)
Take clopidogrel (Plavix) with or without food. But avoid grapefruit or grapefruit juice because they interact with clopidogrel (Plavix) causing the medication to not work as well.
Clopidogrel (Plavix) can make you bleed more easily. Stop taking the medication and get medical help right away if you feel lightheaded, dizzy, are vomiting or coughing up blood, or have blood in your stool. These are signs of bleeding that might be happening inside your body.
Get medical help right away if you fall and hit your head while taking clopidogrel (Plavix). Your provider will want to check to make sure you don't have any brain bleeds.
Clopidogrel (Plavix) interacts with several commonly used medications. Some medications need to be avoided while others might need their dose adjusted or you need closer monitoring. Tell your provider and pharmacist about all of the medications and supplements you're taking before and during treatment with clopidogrel (Plavix) to make sure the combination is as safe for you as possible.
Make sure to eat healthy and exercise regularly while taking clopidogrel (Plavix) to help further lower your risk for a heart attack or stroke.
Don't stop taking clopidogrel (Plavix) unless your provider specifically tells you it's safe to do so. This can cause blood clots to form in your body, which can be severe and life-threatening. If you're wanting to stop clopidogrel (Plavix) or switch to another blood thinner, ask your provider how to do so safely.
What are the risks and warnings for Clopidogrel (Plavix)?
Clopidogrel (Plavix) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Clopidogrel (Plavix) not working as well
Risk factors: Taking omeprazole (Prilosec) or esomeprazole (Nexium) | Having certain genes that make clopidogrel (Plavix) work less
Certain people with a specific gene might not respond as well to clopidogrel (Plavix) because of how their bodies break down the medication. Don't start any new medications, vitamins, or supplements without first talking to your healthcare provider or pharmacist, since they could interfere with how clopidogrel (Plavix) works.
Bleeding
Risk factors: Taking other medications that raise the risk for bleeding
Taking clopidogrel (Plavix) can raise your risk for bleeding. Also, this medication might make it take longer than usual for bleeding to stop. You might also notice that you get bruises more easily or have more bleeding when you get a cut or nosebleed. Your risk is higher if you're also taking other medications that can cause bleeding. Tell your provider right away if you notice any abnormal bleeding, see any blood in your stool or urine, or feel more dizzy. Get medical help right away if you have a fall, head injury, or other kinds of physical injury since you might have bleeding inside your body. And contact your provider right away if you have dark or tarry stool or bleeds that are difficult to stop.
Risk of heart attack or stroke if stopped suddenly
Don't stop taking clopidogrel (Plavix) unless your provider specifically tells you it's safe to do so. Stopping the medication too early can cause a heart attack or stroke. If you're wanting to stop clopidogrel (Plavix), contact your provider so they can create a safe plan for you.
Thrombotic thrombocytopenic purpura (TTP)
Clopidogrel (Plavix) can cause a rare, life-threatening blood condition called thrombotic thrombocytopenic purpura (TTP) where blood clots form in small blood vessels. Sometimes it can happen within the first 2 weeks of starting clopidogrel (Plavix). Get medical help right away if you have fever, unusual bleeding, easy bruising, weakness, dizziness, tiredness, or trouble breathing.
Allergic reaction
Risk factors: Allergy to prasugrel (Effient) or ticagrelor (Brilinta)
Allergic reactions to clopidogrel (Plavix) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis. If you are allergic to prasugrel (Effient) or ticagrelor (Brilinta), you might also be allergic to clopidogrel (Plavix). Stop taking clopidogrel (Plavix) and call your doctor if you notice a rash or hives after taking this medication. Get medical help right away if you experience swelling in your face, throat, or tongue.
Strengths
Tablet
75mg
300mg
Dosages
The typical dose is 75 mg by mouth once a day.
For people who are in the hospital right after a heart attack, a single 300-mg loading dose is given first.
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Interactions
Clopidogrel (Plavix) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Clopidogrel (Plavix). Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Defibrotide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Minor bleeding (5%)
Major bleeding (4%)
Other Side Effects
Bruising
Itchiness
Nosebleeds
Stomach and intestinal ulcers
Headache
Changes in taste
Confusion
Serious Side Effects
Contact your healthcare provider immediately if you experience any of the following.
Severe bleeding: feeling faint, lightheaded, dizziness, vomiting blood, bloody or dark-colored stools, severe stomach pain or discomfort
Thrombotic thrombocytopenic purpura (a blood clotting problem): headache, confusion, dizziness, fever, bleeding in your skin, bruising, tiredness, stomach pain, blood in urine, making less urine
When do Clopidogrel (Plavix) possible side effects begin and end?
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Change in taste bad unusual or unpleasant (after) taste
Difficulty in moving
Loss of sense of taste
Muscle aches, cramps, or stiffness
Redness or swollen joints
Seeing, hearing, or feeling things that are not there
Common Concerns
Yes, clopidogrel (Plavix) is an antiplatelet medication. It stops platelets from clumping up together and forming blood clots. Because of this, blood thinners like clopidogrel (Plavix) raise your risk for bleeding and bruising. Make sure to contact your provider if you notice unusual bleeding (e.g., bloody urine or stool, coughing up or vomiting blood) or having trouble stopping a bleed.
Clopidogrel (Plavix) interacts with several medications. Don't take omeprazole (Prilosec) or esomeprazole (Nexium) with clopidogrel (Plavix) because they can lower how well clopidogrel (Plavix) works. You also should be careful when taking NSAIDs (e.g., ibuprofen (Advil), naproxen (Aleve)) because these can raise your risk of bleeding. Also, there are other medications that raise your risk of bleeding, such as certain antidepressants and anticoagulants). Make sure to tell your provider about all medications and supplements you're taking. They can help check for interactions and make sure your medications are safe to take with clopidogrel (Plavix).
Avoid grapefruit or grapefruit juice while taking clopidogrel (Plavix) because it can make clopidogrel (Plavix) not work as well, which raises your risk for a heart attack or stroke. Other than that, there aren't any other specific foods that affect clopidogrel (Plavix). In fact, foods like leafy green vegetables that are typically limited with warfarin (Coumadin) (another common blood thinner), can still be eaten while taking clopidogrel (Plavix).
Yes. Clopidogrel (Plavix) works well to lower your risk of having a stroke or heart attack, but it's still possible to have a stroke or heart attack even while you're taking this medication. This is because your risk for these events depends on several things, like your medical conditions, other medications you're taking, and your lifestyle. It's important to do what you can to keep your risk as low as possible, such as eating healthy and regular exercise.
You need to stop clopidogrel (Plavix) 5 days before any surgery or procedure with a high risk of bleeding. But it's important to discuss with your provider if you should stop taking clopidogrel (Plavix). This is because not all surgeries or procedures require you to stop the medication.
It varies. In general, clopidogrel (Plavix) is initially taken for a month to at least 1 year, depending on the reason you're taking the medication. But, the length of time you need clopidogrel (Plavix) will depend on your specific situation and risk factors for bleeding or clotting. Some people need to take it for just a few months while others might need it for the rest of their lives. Don't stop taking clopidogrel (Plavix) unless your provider specifically told you to do so.
While both clopidogrel (Plavix) and aspirin are antiplatelets medications, they work slightly differently from each other. There are many studies to see if using either medication alone or both together works better to prevent heart attacks and strokes. In general, research shows using both medications in people with heart problems works better, but also raises the risk of bleeding. Also, according to the 2021 stroke prevention guidelines, only people with certain severe types of stroke should use both aspirin and clopidogrel (Plavix). Your provider might suggest using either one or both medications based on your specific situation and needs.
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