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Plavix (clopidogrel bisulfate, antiplatelet agent)

Plavix is commonly used to prevent platelets in your blood from sticking together and forming a blood clot. Clot formation contributes to adverse cardiovascular events, such as stroke or myocardial infarction.

Plavix

Uses

What is Plavix used for?

  • Prevent atherothrombotic events
  • Acute coronary syndrome
  • Combination therapy with aspirin

How should I take Plavix?

Read the directions on the packaging for complete information. Check the label and expiration date.

For oral dosage forms, swallow it whole without chewing, crushing, or dissolving it in liquid. Take it with or without food.

How do I store Plavix?

Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using Plavix?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A= No risk
  • B= No risk in some studies
  • C= There may be some risk
  • D= Positive evidence of risk
  • X= Contraindicated
  • N= Unknown

Breastfeeding:

Not known whether drug is excreted in breast milk.

Always consult your health care provider prior to using this medication if you are pregnant, breastfeeding.

Side Effects

What side effects can occur from Plavix?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Chest pain
  • Collection of blood under the skin
  • Deep, dark purple bruise
  • Itching, pain, redness, or swelling
  • Pain in general
  • Red or purple spots on the skin, varying in size from pinpoint to large bruises

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Plavix?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • CYP2C19 inhibitors
  • Proton pump inhibitors (PPI)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Warfarin (CYP2C9 Substrates)
  • SSRIs and SNRIs

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with Plavix?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Plavix?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Bleeding or blood clotting disorder, such as TTP (thrombocytopenic purpura) or hemophilia
  • A history of stroke, including TIA
  • Stomach ulcer or ulcerative colitis
  • Kidney disease

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Acute coronary syndrome

  • <75 years
    • 300 mg loading dose followed by 75 mg for 14 days up to 12 months (if no bleeding).
    • Concomitant therapy with aspirin: administer in combination with aspirin 75-325 mg each day with or without thrombolytics.
  • >75 years
    • No loading dose.
    • 75 mg for 14 days up to 12 months (if no bleeding).

Recent MI, stroke, or established peripheral arterial disease

  • 75 mg by oral route daily without a loading dose.
  • Recommended as alternative to aspirin or concomitantly with aspirin if patients are not at bleeding risk but at high risk for cardiovascular disease.

Coronary artery disease

75 mg by oral route daily.

Cardioembolic stroke

Prophylaxis if patients are not candidate for oral anticoagulation.

75 mg/day by oral route.

Carotid artery stenting (Off-label)

300 mg by oral route plus aspirin 81-325 mg for 1 dose on day before carotid artery stenting (CAS), then 75 mg/day by oral route plus aspirin 81-325 mg/day for at least 30 days after CAS.

Alternative: 300-600 mg by oral route once, then 75 mg/day for 4 days before CAS in combination with aspirin 81-325 mg/day.

What is the dose for a child?

There is no established pediatric dose for Plavix. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Plavix available?

Plavix is available in the following dosage forms and strengths:

  • Oral tablets: 75 mg, 300 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Plavix https://www.mims.com/philippines/drug/info/plavix Accessed July 6, 2021

Plavix https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=01b14603-8f29-4fa3-8d7e-9d523f802e0b Accessed July 6, 2021

Clinical Outcomes of Plavix and Generic Clopidogrel for Patients Hospitalized With an Acute Coronary Syndrome https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.117.004194 Accessed July 6, 2021

DA Drug Safety Communication: Reduced effectiveness of Plavix (clopidogrel) in patients who are poor metabolizers of the drug https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fda-drug-safety-communication-reduced-effectiveness-plavix-clopidogrel-patients-who-are-poor Accessed July 6, 2021

Clopidogrel. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 6, 2021. http://online.lexi.com

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Written by Stephanie Nicole Nera, RPh, PharmD Updated Jul 07
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