Plavix is a prescription drug that prevents platelets from clumping together and forming blood clots. It helps blood flow more easily and reduces the risk of a future stroke or heart attack.

Plavix is the brand name for the generic drug clopidogrel.

The drug is an oral, antiplatelet drug of the thienopyridine class. Antiplatelet medicines improve the circulation of the arteries.

Plavix may be used as part of combination therapy alongside other drugs. It carries a black-box warning from the United States (U.S.) Food and Drug Administration (FDA) for liver function. Black box warnings alert doctors and patients to dangerous effects.

This article explains how Plavix works, and what it is used for. It will also highlight any adverse effects, warnings, dangers, and drug interactions of Plavix.

Fast facts on Plavix

  • Plavix is a blood-thinning medication used to treat coronary heart disease and peripheral vascular disease.
  • It carries a Food and Drug Administration (FDA) boxed warning for effects on the liver.
  • Patients must always speak to a doctor before taking Plavix. There are adverse effects and Plavix can interact with other drugs.
  • Plavix is safe for unborn children, but it is important to discuss any pregnancy plans with a doctor if they are prescribing Plavix.
  • Not every pharmacist stocks branded Plavix, so it is best to call ahead and make sure it is in stock. Store Plavix in a cool, dry place.

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Plavix is an antiplatelet drug.

Plavix works by keeping platelets apart and stopping them sticking together and forming clots. It helps reduce the risk of a future stroke or heart attack in this way.

The drug achieves this effect as it is a platelet inhibitor. It reduces the number of platelets in the blood. This limits the ability of the blood to clot.

Plavix is used to prevent blood clots in patients who have recently had a heart attack or stroke and those with cerebrovascular disease.

Cerebrovascular disease affects the blood vessels that supply blood and oxygen to the brain. Patients face a high risk of a stroke following a diagnosis.

How to take it

Plavix is available in oral 75-milligram (mg) and 300-mg doses.

In cases of peripheral arterial disease, or a recent heart attack or stroke, a person will take a 75-mg dose daily.

People with acute coronary syndrome will often be started with a loading dose of 300 mg to ensure that the intended effects of the drug are felt sooner. The remaining doses of 75 mg will then be taken once daily.

The drug has not been proven suitable for children under 18 years of age.

Doctors prescribe Plavix in cases where blood clotting could pose a health threat.

Coronary heart disease

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Plavix is prescribed to treat coronary heart disease.

Plavix can help patients with coronary heart disease (CHD), also known as coronary artery disease (CAD). In CHD, one or more arteries do not supply enough blood to the heart.

This usually happens because the arteries have hardened. The hardening of arteries is called atherosclerosis.

CHD is a major cause of illness and death around the world. It starts when plaque, a substance made of hard cholesterol, collects within a coronary artery.

As the plaque builds up, it can lead to the formation of small blood clots. These clots can stop blood reaching the heart muscle.

Chest pain, also known as angina pectoris, is a common symptom. CHD can lead to a heart attack or sudden death.

Peripheral vascular disease

Peripheral vascular disease (PVD) refers to diseases of the blood vessels that are not directly connected to the heart. The peripheral blood vessels narrow, and blood flow is restricted. It mostly occurs in the legs, and sometimes in the arms.

The patient may first notice tired and aching leg muscles, especially when walking. Symptoms may resolve during rest.

As the disease gets worse, symptoms will appear even during light exertion. Eventually, they will be present all the time. When the disease is severe, the leg and foot may feel cold when touched, and the patient will feel constant numbness. Gangrene can develop in some cases.

Plavix can be important in limiting the harmful effects of these conditions.

Plavix has some unintended adverse effects that warrant a degree of caution when taking the drug.

Taking Plavix can commonly lead to bleeding and itchy skin.

More serious adverse effects can also occur, including:

  • unexplained or persistent bleeding
  • blood in the urine that changes the color pink, brown, or red
  • red or tar-black stools
  • unexplained, growing bruises
  • coughing up or vomiting blood

Thrombocytopenic purpura (TTP) can also occur as a result of taking Plavix. This is a condition that causes blood clots to appear anywhere in the body, leading to severe symptoms. These include:

  • purple colored spots in the mouth or bleeding under the skin
  • jaundice
  • fatigue
  • pale skin
  • high body temperature
  • tachycardia, or fast heart rate
  • difficulty breathing
  • headache
  • difficulty understanding speech and language
  • confusion
  • coma
  • stroke
  • seizure
  • low urine output
  • abdominal pain
  • nausea
  • diarrhea
  • vision loss

If you notice any of these symptoms, contact a doctor immediately.

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Always consult with a doctor before taking Plavix.

Plavix comes with important warnings.

Some people have genetic factors that keep their liver from converting Plavix to its active form. Doctors may recommend a genetic test before prescribing the drug. In 2010, the Food and Drug Administration (FDA) added a boxed warning about this.

It is also important never to stop taking Plavix without first consulting a doctor, as there may be a risk of a stroke or heart attack.

Plavix is currently regarded as safe for unborn children. However, if Plavix or clopidogrel are being considered as treatment options, it is always best to raise any current pregnancy or plans to become pregnant with the prescribing doctor.

Some medications and supplements may reduce the effects of Plavix. This can leave the patient at a higher risk of a heart attack or stroke.

Examples include:

Some blood thinners and other drugs may also have this effect.

If Plavix is used with certain medications, such as aspirin, this can increase the risk of potentially life-threatening bleeding. People with a stomach ulcer should not use Plavix for this reason.

People should always make sure their doctor knows which medications and supplements they are taking before the issue of a new prescription.

The Patient Information Label (PIL) for Plavix notes that people with a kidney or liver disorder or those who have recently had surgery should inform their doctor. The PIL contains the complete list of adverse effects.

In 2015, the FDA added a safety warning, noting that people have experienced disorders affecting the skin and areas under the skin when taking Plavix.

Plavix requires some general considerations before use, relating to storage, travel, and monitoring requirements. These include:

  • Take the tablet whole: Do not crush or cut the tablet.
  • Call the pharmacy ahead of visiting: If Plavix has been prescribed, not every pharmacist stocks the branded version as opposed to the generic product.
  • Store correctly: Clopidogrel requires storage in a dry place at room temperature, about 77°F or 25°C. Do not leave this medication in the car.
  • Carry the prescription with you when traveling by air: This will allow airport security to identify the drugs as necessary for health reasons.
  • Avoid elective dental work or operations while taking Plavix: Plavix impacts bleeding time and platelet production for 7 to 10 days. Avoid surgery that is not medically essential during this time to avoid the risk of severe bleeding.

As long as you take Plavix exactly as prescribed by a doctor, it can greatly reduce the risk of a fatal heart complication in people who otherwise would run the risk of experiencing one.

For full information, please refer to the Patient Information Leaflet.