Plavix (Clopidogrel) - Oral

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What Is Plavix? 

Plavix (clopidogrel) is an oral tablet prescription medication used to prevent blood clots in people with certain risk factors.

It is an antiplatelet medication (blood thinner), also known as a platelet aggregation inhibitor, that reduces the risk of harmful blood clots forming in blood vessels throughout the body. Plavix works by binding to platelets, which are small blood cells that stick together to stop or prevent excessive bleeding.

Drug Facts

  • Generic Name: Clopidogrel
  • Brand Name(s): Plavix
  • Administration Route(s): Oral
  • Drug Availability: Prescription
  • Therapeutic Classification: Platelet aggregation inhibitor
  • Available Generically: Yes
  • Controlled Substance: N/A
  • Active Ingredient: Clopidogrel
  • Dosage Form(s): Tablet

What Is Plavix Used For?

Plavix is indicated to reduce the risk of harmful blood clots in people with certain risk factors. The Food and Drug Administration has approved it for use in acute coronary syndrome (ACS), also known as coronary artery disease, and for certain vascular diseases (conditions that affect the blood vessels). 

ACS occurs when blood supply to the heart muscle is suddenly blocked. The condition can cause an acute myocardial infarction (MI, or heart attack) or warning signs of a potential heart attack.

ACS can include:

Angina is a feeling of chest pain and chest tightness, usually with severe distress and shortness of breath. It can be a symptom of an ongoing or impending heart attack or a warning sign that you are at risk of having a heart attack.

Plavix can also treat the following vascular conditions:

These conditions are caused by obstruction of blood flow due to the presence of a blood clot in an artery. Obstructed blood flow leads to a deficiency of blood to the body’s organs. Experiencing any of these problems can cause severe damage to the heart, brain, or peripheral tissue.

How to Take Plavix

Plavix is an oral medication taken by mouth as a tablet. You can take it with or without food. Do not crush or cut the tablet before taking it. It is best to take it at the same time every day to maintain a consistent effect.

Storage

Store Plavix at a temperature of 77 degrees F. However, it is OK to expose Plavix to temperatures between 59 and 86 degrees F.

Make sure to keep the medication in its original labeled container and away from children or pets.

Off-Label Uses

Healthcare providers sometimes prescribe Plavix to treat other conditions not specified by the FDA when medically appropriate. This is known as off-label use.

Plavix is most often used off-label to prevent blood clots after arterial stent placement. A stent is a device that is placed inside a narrowed blood vessel, such as in the coronary (heart) arteries, to widen it so that blood can flow more easily.

How Long Does Plavix Take to Work?

Plavix can begin to have some effects within two hours of taking it when given as a high first dose (loading dose). Doses of 50 to 100 mg per day can be detected by the second day of treatment.

What Are the Side Effects of Plavix?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

This medication can cause some side effects, most of which are mild and not dangerous. However, some side effects of Plavix are serious and can be life-threatening. Be sure to mention any side effects you experience to your healthcare provider.

Common Side Effects

The most common side effect of Plavix is mild or non-life-threatening bleeding. Bruising or prolonged bleeding after a cut or small wound may also occur. You might notice these effects after minor injuries or sometimes without having a specific injury.

Severe Side Effects

Sometimes, Plavix can cause harmful side effects that require medical attention.

Severe side effects of Plavix include: 

  • Anemia due to chronic blood loss
  • Gastrointestinal bleeding, blood in the stool, or vomiting blood
  • Bleeding in the lungs and coughing up blood
  • Extensive, rapid, acute blood loss
  • Allergic reaction, with rash and difficulty breathing 
  • Hemorrhagic stroke (bleeding in the brain), which can cause a severe, sudden headache, weakness, vision changes, a seizure, or change in consciousness 
  • Inflammation, which can affect the lungs, gastrointestinal system, or skin, with a variety of possible symptoms

Seek immediate medical attention if you experience any of these symptoms. 

Long-Term Side Effects

Generally, side effects of Plavix reverse within approximately one week after stopping the medication. However, some lasting side effects can occur. 

Long-term side effects of Plavix include: 

  • Thrombotic thrombocytopenic purpura: A rare disorder caused by blood clots throughout the body, with varying effects, including anemia and organ dysfunction.
  • Neurological deficits: A hemorrhagic stroke can cause serious brain damage, potentially with lasting deficits that may include vision loss, behavioral and memory changes, weakness, and speech impairment. 
  • Organ damage: A blood clot or a bleed within an organ, such as the kidneys, lungs, or liver, can cause severe and lasting damage.

Report Side Effects

Plavix may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Plavix Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


For oral dosage form (tablets):

For prevention of heart attack or stroke in patients with acute coronary syndrome (ACS):

  • Adults—At first, 300 milligrams (mg) taken as a single dose. Then, a maintenance dose of 75 mg once a day. Your doctor may also give you aspirin together with this medicine.
  • Children—Use and dose must be determined by your doctor.

For prevention of heart attack or stroke in patients with a history heart attack, stroke, or peripheral arterial disease:

  • Adults—75 milligrams (mg) once a day.
  • Children—Use and dose must be determined by your doctor.

Modifications

No dosage adjustment is necessary for older people or patients with liver impairment.

Missed Dose

If you miss a dose, take Plavix as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next dose at your regular time. Do not take two doses of Plavix at the same time until your doctor tells you to do so.

Overdose: What Happens If I Take Too Much Plavix?

Overdose can cause serious complications, including vomiting, difficulty breathing, and hemorrhage. If you take more than the recommended dose, seek medical attention. A Plavix overdose can be treated with a platelet transfusion.

What Happens If I Overdose On Plavix?

If you think you or someone else may have overdosed on Plavix, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Plavix, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

Your doctor may do a genetic test before prescribing this medicine to determine if you have a deficiency in a liver enzyme called CYP2C19. This medicine may not work as well if you have this condition.

Tell all medical doctors, dentists, nurses, and pharmacists you go to that you are taking this medicine. Clopidogrel may increase the risk of serious bleeding during a surgery, other medical procedures (eg, coronary stent procedure), or some kinds of dental work. You may need to stop using this medicine at least 5 days before a surgery, medical procedure, or dental work. Do not stop taking your medicine without your doctor's permission.

While you are using this medicine, if you have any kind of bleeding, it may take longer than usual to stop, especially if you hurt yourself. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Be careful when using sharp objects, including razors and fingernail clippers.

This medicine may increase your chance of bleeding or bruising. Check with your doctor right away if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin. Avoid picking your nose. If you need to blow your nose, blow it gently.

Do not change your dose or stop taking this medicine without checking first with your doctor.

Check with your doctor right away if you have a change in mental status, dark or bloody urine, difficulty with speaking, fever, pale color of the skin, pinpoint red spots on the skin, seizures, weakness, yellow eyes or skin. These may be symptoms of a rare and serious condition called thrombotic thrombocytopenic purpura (TTP).

This medicine may cause allergic reactions, including angioedema, which can be life-threatening and require medical attention. Check with your doctor right away if you have large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, sex organs.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Plavix? 

You should not take Plavix if you have ever had an allergic reaction to the medication, a bleeding disorder, or active bleeding, such as a gastrointestinal bleed (can appear as dark or red stools or vomiting blood). If you develop bleeding while on treatment, seek medical attention right away. Abruptly stopping Plavix can be dangerous. 

Talk to the healthcare provider who prescribed this medication to you before you have any surgery or invasive procedure. Your provider might tell you to stop taking it at least five days before the procedure to prevent excessive bleeding.

What Other Medications Interact With Plavix? 

Several medications can interact with Plavix. Be sure to tell your healthcare provider about any other over-the-counter and prescription medications, supplements, and herbs that you are taking.

According to the manufacturer, the following medications interact with Plavix:

  • CYP2C19 inhibitors
  • Prilosec (omeprazole) or Nexium (esomeprazole)
  • Opioids
  • NSAIDs
  • Warfarin
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)
  • Repaglinide

Proton pump inhibitors (PPIs), such as Prilosec and Prevacid, can increase the effect of Plavix. The FDA has issued a warning about using them together.

What Medications Are Similar? 

Many available medications are used to prevent blood clots through varying biological mechanisms. For example, antiplatelet medications also work to inhibit platelet activity, but in a different way than Plavix.

Examples of antiplatelet medications include:

Anticoagulants, also known as blood thinners, work by inhibiting certain aspects of blood clotting that are not specifically related to platelets. 

Examples of anticoagulant medications include:

Frequently Asked Questions

  • What is Plavix used for?

    Plavix is used to prevent blood clots if you have a high risk of blood vessel blockage and blood clots.

  • How does Plavix work?

    Plavix binds to platelets and reduces their ability to form a clot. Platelets are small cells in the blood that normally bind together and with other substances to prevent bleeding.

  • What drugs should not be taken with Plavix?

    Avoid taking other blood thinners, including aspirin, warfarin, and Eliquis (apixaban), while on Plavix. You should also avoid taking proton pump inhibitors (PPIs), opioids, repaglinide, and SSRIs or SNRIs (commonly used to treat depression).

  • How long does it take for Plavix to work?

    Plavix can begin to have some effects within two to 24 hours. It reaches a steady state in the body after it is taken daily for three to seven days. It can continue to affect the platelets for seven to 10 days. The body’s blood clotting function returns to normal about five days after stopping Plavix.

  • What are the side effects of Plavix?

    Side effects of Plavix include prolonged bleeding from wounds, bruising, gastrointestinal bleeds, and risk of dangerous bleeding, such as hemorrhagic stroke.

  • How do I safely stop taking Plavix?

    You should only stop taking Plavix under the guidance of your healthcare provider. Abruptly stopping may increase the risk of blood clots. Depending on your underlying condition, you might receive a schedule for stopping Plavix or another medication to start taking once you stop Plavix.

How Can I Stay Healthy While Taking Plavix? 

Plavix is safe when used as directed. However, if you take Plavix, this means that you likely have an underlying vascular condition and may need to take further steps to improve your health.

Staying healthy while taking Plavix involves the following: 

  • Getting regular medical surveillance of blood pressure, blood sugar, fat and cholesterol blood levels, heart function and heart rhythm, carotid arteries, and peripheral blood flow
  • Taking all of your medications as prescribed and reporting side effects to your doctor promptly 
  • Following dietary guidelines that are recommended for your condition

There are some risks associated with Plavix, so you should avoid factors that can increase the likelihood of side effects. 

You can reduce the risk of side effects by avoiding activities that can cause injury. Additionally, tell your medical provider that you take Plavix before undergoing any surgery or procedure.

Seek medical attention if you experience:

  • A severe and unexpected headache
  • Excessive bleeding from a wound
  • Severe bruising
  • Excessive pain
  • Blood in the stool or urine blood
  • Coughing or vomiting blood 

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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